Myocardial infarction with nonobstructive coronary arteries - the European PERspective (SNIPER) survey
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MORRONE, Doralisa; Giulio STEFANINI; De Carlo MARCO; Cristina GIANNINI; Gabor TOTH; Dan PRUNEA; Carlo ZIVELONGHI; Alice BENEDETTI; De Bruyne BERNARD; Adriaan WILGENHOF; Jan KANOVSKY; Petr KALA; Lene HOLMVANG; Markus HASBAK; David HILDICK-SMITH; James COCKBURN; Nicolas AMABILE; Aurelie VEUGEOIS; Thomas HOVASSE; Antoinette NEYLON; Benjamin HONTON; Bruno FARAH; Tommaso GORI; Maike KNORR; Alexander WOLF; Thomas SCHMIT; Jorg HAUSLEITER; K. KONSTANTIN STARK; Mohamed ABDEL-WAHA; Hans-josef FEISTRITZER; Felix WOITEK; Axel LINKE; Jurgen LEICK; Shazia AFZAL; Dimitrios ALEXOPOULOS; Charalampos VARLAMOS; Kostantinos TSIOUFIS; Kyriakos DIMITRIADIS; Luca TESTA; Mattia SQUILLACE; Federico CONROTTO; Fabrizio D'ASCENZO; Gianluca CAMPO; Marta COCCO; Di Mario CARLO; Flavia CANIATO; Flavio Luciano RIBICHINI; Daniele PRATI; Giuseppe TARANTINI; Francesco CARDAIOLI; Francesco BURZOTTA; Lazzaro PARAGGIO; Francesco BEDOGNI; Luca ARZUFFI; Alaide CHIEFFO; Giulia GHIZZONI; Giedrius DAVIDAVICIUS; Povilas BUDRYS; Van Mieghem NICOLAS; Joost DAEMEN; Regine BRINKMANN; Hendrik BANTE; Maciej LESIAK; Sylwia IWANCZYK; Jerzy PREGOWSKI; Jaroslaw SKOWRONSKI; Sergio MADEIRA; Luis RAPOSO; Rodrigo ESTEVEZ-LOUREIRO; Antonio SISINNI; Javier ESCANED; Adrian JERONIMO; Raul MORENO; Santiago JIMENEZ-VALERO; Pieter VRIESENDORP; Tobias PUSTJENS; Van Geuns ROBERT; Peter DAMMAN; Van de Hoef TIM; Van der Harst PIM; Mamas A MAMAS; Simon DUCKETT; Ghada MIKHAIL; Carla LUCARELLI; Colin BERRY a De Caterina RAFFAELE
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Journal of Cardiovascular Medicine, Philadelphia, Lippincott Williams & Wilkins, 2025, 1558-2027
Background and aimsMyocardial infarction with nonobstructive coronary arteries (MINOCA) is a heterogeneous group of clinical entities requiring further investigation to assess prognosis and guide treatment. We evaluated current diagnostic practices across European academic centres in its diagnosis and management, to focus on current gaps in clinical practice.MethodsBetween June and October 2023, we distributed an electronic survey to 42 centres selected from a 2023 list of European Association of Percutaneous Cardiovascular Interventions Hosting Academic Centres, obtaining information on demographics of MINOCA, perceived clinical impact, testing and treatments.ResultsThe analysis was based on data from 41 centres. According to the survey, MINOCA accounts for approximately 10% of MI cases. Only 38% of the respondents perceived MINOCA as increasing the risk for future major adverse cardiovascular events. Sixty-three percent of centres agreed on the need for further testing after MINOCA diagnosis, and 22% reported proceeding with a comprehensive diagnostic algorithm. Intravascular (51%) and cardiac magnetic resonance imaging (50%) were the most common diagnostic tools used. Coronary plaque disruption was perceived as the most frequent cause based on respondents' opinions. Sixty-nine percent of centres considered 'empiric' therapy acceptable without functional testing.ConclusionsThis survey revealed a significant heterogeneity in the diagnostic approaches to MINOCA in academic European centres, with variable belief of its clinical impact, wide variation in diagnostic algorithms, noteworthy diagnostic inertia, and poor adherence to guideline recommendations. All these point to a pressing need for a unified approach to MINOCA testing and a much closer alignment to guidelines.
MORRONE, Doralisa; Giulio STEFANINI; De Carlo MARCO; Cristina GIANNINI; Gabor TOTH; Dan PRUNEA; Carlo ZIVELONGHI; Alice BENEDETTI; De Bruyne BERNARD; Adriaan WILGENHOF; Jan KANOVSKY; Petr KALA; Lene HOLMVANG; Markus HASBAK; David HILDICK-SMITH; James COCKBURN; Nicolas AMABILE; Aurelie VEUGEOIS; Thomas HOVASSE; Antoinette NEYLON; Benjamin HONTON; Bruno FARAH; Tommaso GORI; Maike KNORR; Alexander WOLF; Thomas SCHMIT; Jorg HAUSLEITER; K. KONSTANTIN STARK; Mohamed ABDEL-WAHA; Hans-josef FEISTRITZER; Felix WOITEK; Axel LINKE; Jurgen LEICK; Shazia AFZAL; Dimitrios ALEXOPOULOS; Charalampos VARLAMOS; Kostantinos TSIOUFIS; Kyriakos DIMITRIADIS; Luca TESTA; Mattia SQUILLACE; Federico CONROTTO; Fabrizio D'ASCENZO; Gianluca CAMPO; Marta COCCO; Di Mario CARLO; Flavia CANIATO; Flavio Luciano RIBICHINI; Daniele PRATI; Giuseppe TARANTINI; Francesco CARDAIOLI; Francesco BURZOTTA; Lazzaro PARAGGIO; Francesco BEDOGNI; Luca ARZUFFI; Alaide CHIEFFO; Giulia GHIZZONI; Giedrius DAVIDAVICIUS; Povilas BUDRYS; Van Mieghem NICOLAS; Joost DAEMEN; Regine BRINKMANN; Hendrik BANTE; Maciej LESIAK; Sylwia IWANCZYK; Jerzy PREGOWSKI; Jaroslaw SKOWRONSKI; Sergio MADEIRA; Luis RAPOSO; Rodrigo ESTEVEZ-LOUREIRO; Antonio SISINNI; Javier ESCANED; Adrian JERONIMO; Raul MORENO; Santiago JIMENEZ-VALERO; Pieter VRIESENDORP; Tobias PUSTJENS; Van Geuns ROBERT; Peter DAMMAN; Van de Hoef TIM; Van der Harst PIM; Mamas A MAMAS; Simon DUCKETT; Ghada MIKHAIL; Carla LUCARELLI; Colin BERRY a De Caterina RAFFAELE. Myocardial infarction with nonobstructive coronary arteries - the European PERspective (SNIPER) survey. Journal of Cardiovascular Medicine. Philadelphia: Lippincott Williams & Wilkins, 2025, roč. 26, č. 12, s. 731-740. ISSN 1558-2027. Dostupné z: https://doi.org/10.2459/JCM.0000000000001808.
@article{2547636, author = {Morrone, Doralisa and Stefanini, Giulio and Marco, De Carlo and Giannini, Cristina and Toth, Gabor and Prunea, Dan and Zivelonghi, Carlo and Benedetti, Alice and Bernard, De Bruyne and Wilgenhof, Adriaan and Kanovsky, Jan and Kala, Petr and Holmvang, Lene and Hasbak, Markus and HildickandSmith, David and Cockburn, James and Amabile, Nicolas and Veugeois, Aurelie and Hovasse, Thomas and Neylon, Antoinette and Honton, Benjamin and Farah, Bruno and Gori, Tommaso and Knorr, Maike and Wolf, Alexander and Schmit, Thomas and Hausleiter, Jorg and Konstantin Stark, K. and AbdelandWaha, Mohamed and Feistritzer, Hansandjosef and Woitek, Felix and Linke, Axel and Leick, Jurgen and Afzal, Shazia and Alexopoulos, Dimitrios and Varlamos, Charalampos and Tsioufis, Kostantinos and Dimitriadis, Kyriakos and Testa, Luca and Squillace, Mattia and Conrotto, Federico and D'ascenzo, Fabrizio and Campo, Gianluca and Cocco, Marta and Carlo, Di Mario and Caniato, Flavia and Ribichini, Flavio Luciano and Prati, Daniele and Tarantini, Giuseppe and Cardaioli, Francesco and Burzotta, Francesco and Paraggio, Lazzaro and Bedogni, Francesco and Arzuffi, Luca and Chieffo, Alaide and Ghizzoni, Giulia and Davidavicius, Giedrius and Budrys, Povilas and Nicolas, Van Mieghem and Daemen, Joost and Brinkmann, Regine and Bante, Hendrik and Lesiak, Maciej and Iwanczyk, Sylwia and Pregowski, Jerzy and Skowronski, Jaroslaw and Madeira, Sergio and Raposo, Luis and EstevezandLoureiro, Rodrigo and Sisinni, Antonio and Escaned, Javier and Jeronimo, Adrian and Moreno, Raul and JimenezandValero, Santiago and Vriesendorp, Pieter and Pustjens, Tobias and Robert, Van Geuns and Damman, Peter and Tim, Van de Hoef and Pim, Van der Harst and Mamas, Mamas A and Duckett, Simon and Mikhail, Ghada and Lucarelli, Carla and Berry, Colin and Raffaele, De Caterina}, article_location = {Philadelphia}, article_number = {12}, doi = {https://doi.org/10.2459/JCM.0000000000001808}, keywords = {intravascular ultrasound; magnetic resonance imaging; myocardial infarction with nonobstructive coronary arteries; optical coherence tomography; vasoreactivity testing}, language = {eng}, issn = {1558-2027}, journal = {Journal of Cardiovascular Medicine}, title = {Myocardial infarction with nonobstructive coronary arteries - the European PERspective (SNIPER) survey}, url = {https://journals.lww.com/jcardiovascularmedicine/abstract/2025/12000/myocardial_infarction_with_nonobstructive_coronary.8.aspx}, volume = {26}, year = {2025} }
TY - JOUR ID - 2547636 AU - Morrone, Doralisa - Stefanini, Giulio - Marco, De Carlo - Giannini, Cristina - Toth, Gabor - Prunea, Dan - Zivelonghi, Carlo - Benedetti, Alice - Bernard, De Bruyne - Wilgenhof, Adriaan - Kanovsky, Jan - Kala, Petr - Holmvang, Lene - Hasbak, Markus - Hildick-Smith, David - Cockburn, James - Amabile, Nicolas - Veugeois, Aurelie - Hovasse, Thomas - Neylon, Antoinette - Honton, Benjamin - Farah, Bruno - Gori, Tommaso - Knorr, Maike - Wolf, Alexander - Schmit, Thomas - Hausleiter, Jorg - Konstantin Stark, K. - Abdel-Waha, Mohamed - Feistritzer, Hans-josef - Woitek, Felix - Linke, Axel - Leick, Jurgen - Afzal, Shazia - Alexopoulos, Dimitrios - Varlamos, Charalampos - Tsioufis, Kostantinos - Dimitriadis, Kyriakos - Testa, Luca - Squillace, Mattia - Conrotto, Federico - D'ascenzo, Fabrizio - Campo, Gianluca - Cocco, Marta - Carlo, Di Mario - Caniato, Flavia - Ribichini, Flavio Luciano - Prati, Daniele - Tarantini, Giuseppe - Cardaioli, Francesco - Burzotta, Francesco - Paraggio, Lazzaro - Bedogni, Francesco - Arzuffi, Luca - Chieffo, Alaide - Ghizzoni, Giulia - Davidavicius, Giedrius - Budrys, Povilas - Nicolas, Van Mieghem - Daemen, Joost - Brinkmann, Regine - Bante, Hendrik - Lesiak, Maciej - Iwanczyk, Sylwia - Pregowski, Jerzy - Skowronski, Jaroslaw - Madeira, Sergio - Raposo, Luis - Estevez-Loureiro, Rodrigo - Sisinni, Antonio - Escaned, Javier - Jeronimo, Adrian - Moreno, Raul - Jimenez-Valero, Santiago - Vriesendorp, Pieter - Pustjens, Tobias - Robert, Van Geuns - Damman, Peter - Tim, Van de Hoef - Pim, Van der Harst - Mamas, Mamas A - Duckett, Simon - Mikhail, Ghada - Lucarelli, Carla - Berry, Colin - Raffaele, De Caterina PY - 2025 TI - Myocardial infarction with nonobstructive coronary arteries - the European PERspective (SNIPER) survey JF - Journal of Cardiovascular Medicine VL - 26 IS - 12 SP - 731-740 EP - 731-740 PB - Lippincott Williams & Wilkins SN - 15582027 KW - intravascular ultrasound KW - magnetic resonance imaging KW - myocardial infarction with nonobstructive coronary arteries KW - optical coherence tomography KW - vasoreactivity testing UR - https://journals.lww.com/jcardiovascularmedicine/abstract/2025/12000/myocardial_infarction_with_nonobstructive_coronary.8.aspx N2 - Background and aimsMyocardial infarction with nonobstructive coronary arteries (MINOCA) is a heterogeneous group of clinical entities requiring further investigation to assess prognosis and guide treatment. We evaluated current diagnostic practices across European academic centres in its diagnosis and management, to focus on current gaps in clinical practice.MethodsBetween June and October 2023, we distributed an electronic survey to 42 centres selected from a 2023 list of European Association of Percutaneous Cardiovascular Interventions Hosting Academic Centres, obtaining information on demographics of MINOCA, perceived clinical impact, testing and treatments.ResultsThe analysis was based on data from 41 centres. According to the survey, MINOCA accounts for approximately 10% of MI cases. Only 38% of the respondents perceived MINOCA as increasing the risk for future major adverse cardiovascular events. Sixty-three percent of centres agreed on the need for further testing after MINOCA diagnosis, and 22% reported proceeding with a comprehensive diagnostic algorithm. Intravascular (51%) and cardiac magnetic resonance imaging (50%) were the most common diagnostic tools used. Coronary plaque disruption was perceived as the most frequent cause based on respondents' opinions. Sixty-nine percent of centres considered 'empiric' therapy acceptable without functional testing.ConclusionsThis survey revealed a significant heterogeneity in the diagnostic approaches to MINOCA in academic European centres, with variable belief of its clinical impact, wide variation in diagnostic algorithms, noteworthy diagnostic inertia, and poor adherence to guideline recommendations. All these point to a pressing need for a unified approach to MINOCA testing and a much closer alignment to guidelines. ER -
MORRONE, Doralisa; Giulio STEFANINI; De Carlo MARCO; Cristina GIANNINI; Gabor TOTH; Dan PRUNEA; Carlo ZIVELONGHI; Alice BENEDETTI; De Bruyne BERNARD; Adriaan WILGENHOF; Jan KANOVSKY; Petr KALA; Lene HOLMVANG; Markus HASBAK; David HILDICK-SMITH; James COCKBURN; Nicolas AMABILE; Aurelie VEUGEOIS; Thomas HOVASSE; Antoinette NEYLON; Benjamin HONTON; Bruno FARAH; Tommaso GORI; Maike KNORR; Alexander WOLF; Thomas SCHMIT; Jorg HAUSLEITER; K. KONSTANTIN STARK; Mohamed ABDEL-WAHA; Hans-josef FEISTRITZER; Felix WOITEK; Axel LINKE; Jurgen LEICK; Shazia AFZAL; Dimitrios ALEXOPOULOS; Charalampos VARLAMOS; Kostantinos TSIOUFIS; Kyriakos DIMITRIADIS; Luca TESTA; Mattia SQUILLACE; Federico CONROTTO; Fabrizio D'ASCENZO; Gianluca CAMPO; Marta COCCO; Di Mario CARLO; Flavia CANIATO; Flavio Luciano RIBICHINI; Daniele PRATI; Giuseppe TARANTINI; Francesco CARDAIOLI; Francesco BURZOTTA; Lazzaro PARAGGIO; Francesco BEDOGNI; Luca ARZUFFI; Alaide CHIEFFO; Giulia GHIZZONI; Giedrius DAVIDAVICIUS; Povilas BUDRYS; Van Mieghem NICOLAS; Joost DAEMEN; Regine BRINKMANN; Hendrik BANTE; Maciej LESIAK; Sylwia IWANCZYK; Jerzy PREGOWSKI; Jaroslaw SKOWRONSKI; Sergio MADEIRA; Luis RAPOSO; Rodrigo ESTEVEZ-LOUREIRO; Antonio SISINNI; Javier ESCANED; Adrian JERONIMO; Raul MORENO; Santiago JIMENEZ-VALERO; Pieter VRIESENDORP; Tobias PUSTJENS; Van Geuns ROBERT; Peter DAMMAN; Van de Hoef TIM; Van der Harst PIM; Mamas A MAMAS; Simon DUCKETT; Ghada MIKHAIL; Carla LUCARELLI; Colin BERRY a De Caterina RAFFAELE. Myocardial infarction with nonobstructive coronary arteries - the European PERspective (SNIPER) survey. \textit{Journal of Cardiovascular Medicine}. Philadelphia: Lippincott Williams \&{} Wilkins, 2025, roč.~26, č.~12, s.~731-740. ISSN~1558-2027. Dostupné z: https://doi.org/10.2459/JCM.0000000000001808.