Coronary artery spasm-induced acute myocardial infarction (CASIAMI) is one of the etiologies of myocardial infarction with non-obstructive coronary arteries (MINOCA). We retrospectively analyzed the incidence and clinical characteristics of Japanese patients with CASIAMI and non-obstructive coronary arteries. We experienced 62 patients with MINOCA (10 thrombosis, 7 unknown causes, and 45 CASIAMI) among 991 patients with suspected AMI. Pharmacological spasm provocation testing was performed in 37 patients. CASIAMI without obstructive coronary arteries was found in 4.5% of patients with suspected AMI and was observed in 73% of patients with MINOCA. Patients with CASIAMI were frequently males and had relatively small AMIs. Spontaneous spasm was recognized in 8 patients. We could reproduce provoked spasm in 37 patients with MINOCA, including 23 patients with multiple spasm. No patients died during the follow-up period. The clinical outcomes in patients with CASIAMI under optimal coronary vasodilators were satisfactory.

冠状动脉痉挛性急性心肌梗死（CASIAMI）是非阻塞性冠状动脉（MINOCA）心肌梗死的病因之一。我们回顾性分析了日本 CASIAMI 和非阻塞性冠状动脉患者的发病率和临床特征。在 991 名疑似 AMI 患者中，我们经历了 62 名 MINOCA 患者（10 名血栓形成，7 名不明原因和 45 名 CASIAMI）。对 37 名患者进行了药理痉挛激发试验。在 4.5% 的疑似 AMI 患者中发现了无阻塞性冠状动脉的 CASIAMI，在 73% 的 MINOCA 患者中发现了 CASIAMI。CASIAMI 患者通常为男性，AMI 相对较小。8 名患者出现自发性痉挛。我们可以在 37 名 MINOCA 患者中重现诱发痉挛，其中多发性痉挛患者23例。随访期间无患者死亡。CASIAMI 患者在最佳冠状动脉血管扩张剂下的临床结果令人满意。