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Updated: May 19, 2026
12:03
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Myocardial infarction without obstructive coronary artery disease
1Cardiovascular Clinical Research Center, New York University School of Medicine, New York, New York, USA. Harmony.Reynolds@nyumc.org
Current Opinion in Cardiology
|September 4, 2012
Summary
Myocardial infarction (MI) without obstructive coronary artery disease (CAD) affects both sexes and has serious outcomes. Plaque rupture is a common cause, necessitating secondary prevention strategies.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Pathophysiology
Background:
- A significant number of myocardial infarction (MI) patients exhibit no obstructive coronary artery disease (CAD) on angiography.
- This condition, more prevalent in women but affecting both sexes, is associated with a notable risk of death or reinfarction.
Purpose of the Study:
- To review the current understanding of MI without obstructive CAD.
- To explore the underlying mechanisms and diagnostic approaches for this patient group.
Main Methods:
- Review of autopsy series to confirm MI without obstructive CAD as a cause of death.
- Analysis of studies utilizing intravascular ultrasound (IVUS) and cardiac MRI (CMR) in patients with MI without obstructive CAD.
- Examination of CMR findings for identifying ischemic and non-ischemic etiologies.
Main Results:
- Autopsy studies confirm MI without obstructive CAD as a cause of mortality.
- IVUS and CMR revealed plaque rupture in approximately 40% of patients.
- CMR identified non-ischemic causes (e.g., myocarditis) and also showed ischemic injury potentially unrelated to plaque rupture, suggesting diverse mechanisms like vasospasm or embolism.
Conclusions:
- MI without obstructive CAD is a heterogeneous condition with varied underlying mechanisms.
- Plaque rupture is a frequent finding.
- Guideline-recommended secondary prevention, including antiplatelet and antiatherosclerotic therapies, is crucial in the absence of a confirmed non-ischemic cause.
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