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Acute Coronary Syndrome with Non-ruptured Plaques (NONRUPLA): Novel Ideas and Perspectives

  • Vascular Biology (J. Hamilton, Section Editor)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

In this review article, we focus on the mechanisms and features of acute coronary syndromes (ACS) with no ruptured plaque (NONRUPLA) highlighting the uncertainties over diagnostic evaluation and treatment.

Recent Findings

The most common cause of ACS is obstruction due to atherosclerotic plaque ruptured or erosion. In 14% of patients who present in the Emergency Department as myocardial infarction, the final diagnosis is ACS with NONRUPLA. Although the clinical presentation of NONRUPLA may mimic myocardial infarction, the underlying pathogenesis is different, and it may guide therapeutic approaches and overall prognosis that vary according to etiology.

Summary

The possible mechanisms of ACS with NONRUPLA are coronary embolism, acute dissection of the aorta or coronary artery, vasospasm, microvascular dysfunction, the imbalance between oxygen demand and supply, coronary trauma and stent complications, direct cellular toxicity and damage, Takotsubo syndrome, and myocardial infarction with non-obstructive coronary arteries (MINOCA).

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Authors and Affiliations

  1. 1st Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, Vasilissis Sofias 114, 11528, Athens, Greece

    Marianna Leopoulou, Vasiliki C Mistakidi, Evangelos Oikonomou, George Latsios, Spyridon Papaioannou, Spyridon Deftereos, Gerasimos Siasos, Alexis Antonopoulos, George Charalambous & Dimitris Tousoulis

Authors
  1. Marianna Leopoulou
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  2. Vasiliki C Mistakidi
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  3. Evangelos Oikonomou
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  4. George Latsios
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  5. Spyridon Papaioannou
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  10. Dimitris Tousoulis
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Contributions

Dr. Oikonomou, Prof. Siasos, and Prof. Tousoulis have reviewed the article; all the other authors have drafted the manuscript.

Corresponding author

Correspondence to Evangelos Oikonomou.

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Conflict of Interest

No potential conflicts of interest. No financial support.

Dr. Leopoulou has nothing to disclose.

Dr. Mistakidi has nothing to disclose.

Dr. Oikonomou has nothing to disclose.

Dr. Latsios has nothing to disclose.

Dr. Papaioannou has nothing to disclose.

Dr. Deftereos has nothing to disclose.

Dr. Siasos has nothing to disclose.

Dr. Antonopoulos has nothing to disclose.

Dr. Charalambous has nothing to disclose.

Dr. Tousoulis has nothing to disclose.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Leopoulou, M., Mistakidi, V.C., Oikonomou, E. et al. Acute Coronary Syndrome with Non-ruptured Plaques (NONRUPLA): Novel Ideas and Perspectives. Curr Atheroscler Rep 22, 21 (2020). https://doi.org/10.1007/s11883-020-00839-7

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  • DOI: https://doi.org/10.1007/s11883-020-00839-7

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