СОВРЕМЕННЫЕ ПОДХОДЫ К ИНФАРКТУ МИОКАРДА БЕЗ СТЕНОЗА КОРОНАРНЫХ АРТЕРИЙ
Аннотация
Инфаркт миокарда без подъёма сегмента ST (NSTEMI) является одной из наиболее распространённых форм острого коронарного синдрома и относится к ведущим причинам смертности и инвалидизации, обусловленных сердечно-сосудистыми заболеваниями. В последние годы у определённой части пациентов с клинической картиной NSTEMI при проведении коронарной ангиографии не выявляются значимые стенозы, что соответствует понятию инфаркта миокарда без обструктивного поражения коронарных артерий (MINOCA). В представленном обзоре литературы освещены патогенетические механизмы, диагностические возможности, принципы оценки риска и персонализированного лечения инфаркта миокарда без обструктивного поражения коронарных артерий. Проведён анализ современных международных клинических рекомендаций, данных крупных регистров и систематических обзоров, посвящённых диагностике и лечению MINOCA. MINOCA представляет собой гетерогенный синдром, включающий различные патогенетические механизмы. Применение современных методов визуализации и этиологически ориентированного лечения способствует улучшению клинических исходов. Показано, что у пациентов с NSTEMI, протекающим в форме MINOCA, комплексная диагностика и механизмо-ориентированное персонализированное лечение являются оптимальной клинической стратегией.
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Об авторах
Список литературы
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