INOCA, ANOCA, and MINOCA: Pathogenesis, Diagnosis and Treatment

Special Issue Editors


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Guest Editor
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), Division of Cardiology, University Hospital Paolo Giaccone, University of Palermo, 90127 Palermo, Italy
Interests: coronary microvascular dysfunction; INOCA; MINOCA; acute coronary syndrome; chronic coronary syndrome; percutaneous coronary intervention; preventive cardiology
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Guest Editor Assistant
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
Interests: chronic coronary syndrome; cardiovascular risk factors; coronary microvascular dysfunction; cardiovascular prevention; cardio-oncology; heart failure

Special Issue Information

Dear Colleagues,

Angina with non-obstructive coronary artery disease (CAD) (ANOCA), ischemia with non-obstructive CAD (INOCA), or myocardial infarction with non-obstructive coronary arteries (MINOCA). Coronary microvascular dysfunction (CMD) occurs when the microvasculature fails to adequately perfuse the myocardium under stress or at rest in microvascular spasm, resulting in ANOCA/INOCA/MINOCA. Evolving evidence now indicates that non-obstructive CAD is the predominant phenotype of ischemic heart disease. These conditions contribute significantly to death, disability, and poor quality of life while consuming significant healthcare resources.

These conditions represent frequent clinical challenges with currently limited treatment options. Progress will be made as we improve our diagnostic testing capabilities and develop therapies specifically designed to address microvascular dysfunction. This Special Issue, titled "INOCA, ANOCA, and MINOCA: Pathogenesis, Diagnosis, and Treatment," aims to provide an overview of the latest insights into the pathophysiology of these conditions, the latest challenges in diagnosis and innovative diagnostic techniques, and emerging treatment strategies on coronary microvascular dysfunction. This Special Issue aims to summarize these syndromes and their associated clinical outcomes, with an emphasis on potential mechanistic signals involving the endothelium, microvasculature, and cardiomyocyte function.

We warmly welcome the state-of-the-art reviews as well as original research articles that explore the intricacies of CMD and provide new perspectives on managing ANOCA, INOCA, and MINOCA effectively.

Dr. Vincenzo Sucato
Guest Editor

Dr. Cristina Madaudo
Guest Editor Assistant

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Keywords

  • coronary microvascular dysfunction
  • acute coronary syndrome
  • MINOCA
  • chronic coronary syndrome
  • INOCA
  • ANOCA

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Published Papers (2 papers)

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Editorial

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5 pages, 419 KiB  
Editorial
The ANOCA/INOCA Dilemma Considering the 2024 ESC Guidelines on Chronic Coronary Syndromes
by Vincenzo Sucato, Cristina Madaudo and Alfredo Ruggero Galassi
J. Cardiovasc. Dev. Dis. 2024, 11(10), 302; https://doi.org/10.3390/jcdd11100302 - 1 Oct 2024
Cited by 1 | Viewed by 4170
Abstract
Cardiovascular disease remains a significant cause of morbidity and mortality worldwide, and its manifestations continue to pose a challenge in clinical practice [...] Full article
(This article belongs to the Special Issue INOCA, ANOCA, and MINOCA: Pathogenesis, Diagnosis and Treatment)
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Review

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18 pages, 1446 KiB  
Review
ANOCA, INOCA, MINOCA: The New Frontier of Coronary Syndromes
by Antonio L. M. Parlati, Ermanno Nardi, Vincenzo Sucato, Cristina Madaudo, Giulio Leo, Tanisha Rajah, Federica Marzano, Maria Prastaro, Paola Gargiulo, Stefania Paolillo, Giuseppe Vadalà, Alfredo Ruggero Galassi and Pasquale Perrone Filardi
J. Cardiovasc. Dev. Dis. 2025, 12(2), 64; https://doi.org/10.3390/jcdd12020064 - 10 Feb 2025
Viewed by 2255
Abstract
The growing prevalence in the diagnosis of INOCA (Ischemia with Non-Obstructive Coronary Arteries), ANOCA (Angina with Non-Obstructive Coronary Arteries), and MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries) highlights the need to reassess their clinical relevance. Historically regarded as benign syndromes, emerging evidence suggests [...] Read more.
The growing prevalence in the diagnosis of INOCA (Ischemia with Non-Obstructive Coronary Arteries), ANOCA (Angina with Non-Obstructive Coronary Arteries), and MINOCA (Myocardial Infarction with Non-Obstructive Coronary Arteries) highlights the need to reassess their clinical relevance. Historically regarded as benign syndromes, emerging evidence suggests that these conditions may cause serious cardiovascular events and considerable long-term disability. Additionally, emerging studies suggest that non-obstructive coronary artery disease (CAD) may have a higher prevalence compared to traditional obstructive forms of CAD. This leads to the need to better clarify the underlying pathogenic mechanisms as well as the risk factors associated with these syndromes. This is precisely the aim of this review, which focuses on the complex and heterogeneous mechanisms underlying these syndromes as well as the associated risk factors. This review also sums up the diagnostic steps necessary to achieve an accurate diagnosis, along with the interventional and pharmacological approaches to be implemented in light of the latest evidence. Full article
(This article belongs to the Special Issue INOCA, ANOCA, and MINOCA: Pathogenesis, Diagnosis and Treatment)
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