AI Article Synopsis
- Current guidelines for acute coronary syndrome (ACS) focus on clinical presentation but are shifting towards understanding the underlying pathophysiology, recognizing that plaque destabilization isn't the only cause.
- The use of intracoronary imaging and biomarkers is helping to identify different ACS types (endotypes), enabling personalized treatment plans and new therapy targets.
- A precision medicine approach for conditions like MYOCARDIAL INFARCTION with non-obstructive coronary arteries (MINOCA) is emphasized, aiming at optimizing diagnosis and treatment to reduce risks and improve outcomes for patients.
Article Abstract
Nowadays, current guidelines on acute coronary syndrome (ACS) provide recommendations mainly based on the clinical presentation. However, greater attention is being directed to the specific pathophysiology underlying ACS, considering that plaque destabilization and rupture leading to luminal thrombotic obstruction is not the only pathway involved, albeit the most recognized. In this review, we discuss how intracoronary imaging and biomarkers allow the identification of specific ACS endotypes, leading to the recognition of different prognostic implications, tailored management strategies, and new potential therapeutic targets. Furthermore, different strategies can be applied on a personalized basis regarding antithrombotic therapy, non-culprit lesion revascularization, and microvascular obstruction (MVO). With respect to myocardial infarction with non-obstructive coronary arteries (MINOCA), we will present a precision medicine approach, suggested by current guidelines as the mainstay of the diagnostic process and with relevant therapeutic implications. Moreover, we aim at illustrating the clinical implications of targeted strategies for ACS secondary prevention, which may lower residual risk in selected patients.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11313297 | PMC |
| http://dx.doi.org/10.3390/jcm13154569 | DOI Listing |
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