Elucidation of clinical practice and pathological conditions of myocardial infarction with non-obstructive coronary arteries (MINOCA)

2022 Fiscal Year Final Research Report

• Project/Area Number: 19K17531
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Kumamoto University
• Principal Investigator: Ishii Masanobu 熊本大学, 大学院生命科学研究部(医), 助教 (70823293)
• Project Period (FY): 2019-04-01 – 2023-03-31
• Keywords: MINOCA / 大気汚染曝露 / DPCデータ / 冠微小循環 / オミクス解析 / 臨床疫学

Outline of Final Research Achievements

In recent years, among acute myocardial infarction, MINOCA (myocardial infarction with non-obstructive coronary arteries), which does not have significant stenosis of 50% or more in the epicardial coronary arteries on angiography, has been paid attention. This study clarified the current status of MINOCA in Japan, in which the clinical characteristics were younger women with more extracardiac comorbidities and fewer coronary risk factors, and the prognosis for MINOCA was not better compared to MI-CAD (coronary artery disease). In addition, short-term exposure to dust and PM2.5 was found to be a risk factor. There are various causes of MINOCA, but coronary spasm is considered to be the most common cause, and I am working to further clarify the pathology.

Free Research Field

循環器内科学

Academic Significance and Societal Importance of the Research Achievements

MINOCAは比較的新しい概念であり、徐々にその認識が広まっている。本研究によって日本におけるMINOCAの診療実態、臨床的特徴が明らかとなったことから、さらに認知度が高まり、診断精度の向上が期待される。しかし、短期予後は閉塞性冠動脈疾患による心筋梗塞と同等か不良であることから、原因の鑑別診断を行い、病因特異的な治療へとつなげることが重要である。
また環境要因として大気汚染物質の曝露がリスクであることが明らかとなったため、大気汚染曝露を避ける患者への生活指導や大気汚染物質を排出させないような技術革新や規制が必要である。