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Sex-specific and ethnicity-specific differences in MINOCA.

Sarena La1,2,3, John Beltrame1,2,3, Rosanna Tavella4,5,6

  • 1Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.

Nature Reviews. Cardiology
|September 29, 2023
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Myocardial infarction with non-obstructive coronary arteries (MINOCA) is increasingly recognized. This review updates knowledge on sex and ethnicity differences in MINOCA, highlighting its complex prognosis and diagnostic challenges.

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Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Medical Diagnostics

Background:

  • Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a complex clinical syndrome requiring further investigation beyond initial angiography.
  • Historically underestimated, MINOCA's prognosis is now understood to be less benign than previously assumed.
  • Existing research on MINOCA lacks comprehensive data regarding sex- and ethnicity-specific differences.

Purpose of the Study:

  • To provide an updated review of the latest evidence on MINOCA.
  • To explore sex-specific and ethnicity-specific differences in MINOCA's clinical features, pathophysiology, treatment, and prognosis.

Main Methods:

  • Literature review of recent studies on MINOCA.
  • Analysis of diagnostic modalities including coronary magnetic resonance angiography and functional angiography.
  • Synthesis of data on patient demographics, focusing on sex and ethnicity.

Main Results:

  • MINOCA is a heterogeneous condition with diverse underlying mechanisms.
  • Recent data indicate a poorer prognosis for MINOCA than previously thought.
  • Significant gaps exist in understanding sex- and ethnicity-specific variations in MINOCA.

Conclusions:

  • MINOCA requires further investigation and a nuanced approach to diagnosis and risk stratification.
  • There is a critical need for more research into sex- and ethnicity-specific differences in MINOCA.
  • Addressing these disparities is essential for improving patient outcomes and tailoring treatment strategies.