ANOCA, INOCA, MINOCA: The New Frontier of Coronary Syndromes

Area of Science:

• Cardiology
• Internal Medicine
• Vascular Biology

Background:

• Increasing diagnoses of INOCA, ANOCA, and MINOCA necessitate re-evaluation of their clinical significance.
• These syndromes, previously underestimated, are now recognized as potential causes of serious cardiovascular events and long-term disability.
• Non-obstructive coronary artery disease (CAD) may be more prevalent than obstructive CAD, requiring further investigation.

Purpose of the Study:

• To clarify the complex and heterogeneous pathogenic mechanisms underlying INOCA, ANOCA, and MINOCA.
• To identify and analyze the risk factors associated with these non-obstructive coronary artery disease syndromes.
• To summarize diagnostic strategies and evidence-based interventional and pharmacological treatments.

Main Methods:

• Literature review focusing on pathogenic mechanisms, risk factors, diagnosis, and treatment of INOCA, ANOCA, and MINOCA.
• Synthesis of current evidence regarding the clinical relevance and management of non-obstructive coronary artery disease.
• Analysis of diagnostic pathways and therapeutic approaches based on recent research.

Main Results:

• Emerging evidence indicates that INOCA, ANOCA, and MINOCA are associated with significant cardiovascular risks and long-term patient disability.
• The prevalence of non-obstructive CAD appears substantial, challenging traditional views of coronary artery disease.
• Understanding the heterogeneous mechanisms and risk factors is crucial for accurate diagnosis and effective management.

Conclusions:

• INOCA, ANOCA, and MINOCA represent a significant and growing clinical challenge in cardiology.
• Further research into underlying mechanisms and risk stratification is essential for improving patient outcomes.
• Accurate diagnosis and tailored therapeutic interventions are critical for managing patients with non-obstructive coronary artery disease.