Τίτλος:
Acute Coronary Syndrome with Non-ruptured Plaques (NONRUPLA): Novel Ideas and Perspectives
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose of Review: In this review article, we focus on the mechanisms and features of acute coronary syndromes (ACS) with no ruptured plaque (NONRUPLA) highlighting the uncertainties over diagnostic evaluation and treatment. Recent Findings: The most common cause of ACS is obstruction due to atherosclerotic plaque ruptured or erosion. In 14% of patients who present in the Emergency Department as myocardial infarction, the final diagnosis is ACS with NONRUPLA. Although the clinical presentation of NONRUPLA may mimic myocardial infarction, the underlying pathogenesis is different, and it may guide therapeutic approaches and overall prognosis that vary according to etiology. Summary: The possible mechanisms of ACS with NONRUPLA are coronary embolism, acute dissection of the aorta or coronary artery, vasospasm, microvascular dysfunction, the imbalance between oxygen demand and supply, coronary trauma and stent complications, direct cellular toxicity and damage, Takotsubo syndrome, and myocardial infarction with non-obstructive coronary arteries (MINOCA). © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Συγγραφείς:
Leopoulou, M.
Mistakidi, V.C.
Oikonomou, E.
Latsios, G.
Papaioannou, S.
Deftereos, S.
Siasos, G.
Antonopoulos, A.
Charalambous, G.
Tousoulis, D.
Περιοδικό:
Current Atherosclerosis Reports
Λέξεις-κλειδιά:
antibiotic agent; anticoagulant agent; beta adrenergic receptor blocking agent; candesartan; dipeptidyl carboxypeptidase inhibitor; diuretic agent; gadolinium; hydroxymethylglutaryl coenzyme A reductase inhibitor; perindopril, acute coronary syndrome; aortic dissection; artery injury; atherosclerotic plaque; bacterial endocarditis; cardiovascular magnetic resonance; cell damage; clinical feature; contrast enhancement; coronary artery atherosclerosis; coronary artery disease; coronary artery dissection; coronary artery obstruction; coronary artery spasm; coronary embolism; cytotoxicity; diagnostic test; electrocardiogram; embolism; emergency ward; heart infarction; human; intravascular ultrasound; medical device complication; microvascular dysfunction; optical coherence tomography; positron emission tomography; prognosis; Review; takotsubo cardiomyopathy; therapy; thrombosis; uncertainty; x-ray computed tomography; acute coronary syndrome; adult; aged; atherosclerotic plaque; complication; differential diagnosis; female; heart infarction; male; middle aged, Acute Coronary Syndrome; Adult; Aged; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Myocardial Infarction; Plaque, Atherosclerotic; Prognosis
DOI:
10.1007/s11883-020-00839-7
