冠状动脉非阻塞性心肌梗死诊疗新进展

Current Status of Management of Myocardial Infarction with Non-obstructive Coronary Arteries

传统观点认为急性心肌梗死的发生是冠状动脉严重狭窄的基础上继发血栓形成,导致心肌缺血坏死。近期几项急性心肌梗死的大型注册研究显示约10%的急性心肌梗死并无阻塞性冠状动脉病变。目前针对该病缺乏系统的诊疗规范,也导致部分患者延误了最佳的治疗时机。现从冠状动脉非阻塞性心肌梗死发病机制、诊断、治疗等方面的最新研究进展予以总结阐述。

Traditionally,acute myocardial infarction is caused by secondary thrombosis based on severe coronary artery stenosis,resulting in myocardial ischemic necrosis.However,several large registry studies showed that near 10%of patients with acute myocardial infarction had non-obstructive coronary arteries.Myocardial infarction with non-obstructive coronary arteries is receiving increasingly attention in term of unclear mechanisms,diagnosis,and management.However,current guidelines do not address the specific management of this disease,which delayed the best treatment for some patients.Thus,in this article,we reviewed the current status of mechanisms,diagnosis and treatment strategies to advance our understanding and management of this disease.