Global Research Topics and Trends of Myocardial Infarction with Nonobstructive Coronary Arteries: A Bibliometric Analysis
-
Tuko Srimulyo
,
Antonius Dwi Saputra
,
Arga Setyo Adji
,
Intan Komalasari
,
Atiyatum Billah
,
Diski Saisa
,
Yudi Her Oktaviano
Abstract
Background: Myocardial infarction with nonobstructive coronary arteries (MINOCA) is a heterogeneous clinical entity characterized by evidence of myocardial infarction (MI) in the absence of obstructive coronary artery disease (CAD) on angiography. This study aimed to explore and visualize the global research trends and hotspots of MINOCA using bibliometric approaches.
Methods: The search was performed on October 1, 2025, using the keyword “MINOCA” and its synonyms. Data were obtained from the Scopus, Web of Science, and PubMed databases and analyzed using RStudio (version 4.5.0), employing the Bibliometrix package (via Biblioshiny) alongside VOSviewer (version 1.6.20) for bibliometric visualization.
Results: A total of 1,562 publications related to MINOCA were identified, showing a marked increase in output over the past decade. The mean number of citations per article was 19.21, with the highest citation count occurring in 2018. International Journal of Cardiology published the most articles, while F. Crea was the most contributing author. The United States, Italy, and China emerged as leading contributors. High-impact articles primarily focused on the pathophysiology, diagnostic algorithms, and prognosis of MINOCA. Keyword analysis revealed evolving research hotspots, including pathophysiology, imaging diagnostics, prognosis, therapy, and sex differences, indicating a growing focus on precision diagnostics and patient-tailored management strategies in MINOCA research.
Conclusion: The research landscape of MINOCA has expanded substantially, with growing attention to its underlying mechanisms and diagnostic challenges. Future studies should prioritize the development of standardized diagnostic criteria and the implementation of tailored therapeutic approaches. This bibliometric analysis provides a valuable framework for clinicians and researchers to navigate the evolving field of MINOCA.
1. Agewall S, Beltrame JF, Reynolds HR, Niessner A, Rosano G, Caforio ALP, et al. ESC working group position paper on myocardial infarction with non-obstructive coronary arteries. Eur Heart J. 2017;38(3):143-53.
2. Tamis-Holland JE, Jneid H, Reynolds HR, Agewall S, Brilakis ES, Brown TM, et al. Contemporary Diagnosis and Management of Patients with Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement from the American Heart Association. Circulation. 2019;139(18): e891-908.
3. Pasupathy S, Air T, Dreyer RP, Tavella R, Beltrame JF. Systematic review of patients presenting with suspected myocardial infarction and nonobstructive coronary arteries. Circulation. 2015;131(10):861-70.
4. Reynolds HR, Maehara A, Kwong RY, Sedlak T, Saw J, Smilowitz NR, et al. Coronary Optical Coherence Tomography and Cardiac Magnetic Resonance Imaging to Determine Underlying Causes of Myocardial Infarction with Nonobstructive Coronary Arteries in Women. Circulation. 2021;143(7):624-40.
5. Tognola C, Maloberti A, Varrenti M, Mazzone P, Giannattasio C, Guarracini F. Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA): Current Insights into Pathophysiology, Diagnosis, and Management. Diagnostics. 2025;15(7):1-18.
6. Nordenskjöld AM, Baron T, Eggers KM, Jernberg T, Lindahl B. Predictors of adverse outcome in patients with myocardial infarction with non-obstructive coronary artery (MINOCA) disease. Int J Cardiol. 2018; 261:18-23.
7. Bairey Merz CN, Pepine CJ, Walsh MN, Fleg JL, Camici PG, Chilian WM, et al. Ischemia and No Obstructive Coronary Artery Disease (INOCA). Circulation. 2017;135(11):1075-92.
8. Pustjens TFS, Appelman Y, Damman P, ten Berg JM, Jukema JW, de Winter RJ, et al. Guidelines for the management of myocardial infarction/injury with non-obstructive coronary arteries (MINOCA): a position paper from the Dutch ACS working group. Neth Heart J. 2020;28(3):116-30.
9. Donthu N, Kumar S, Mukherjee D, Pandey N, Lim WM. How to conduct a bibliometric analysis: An overview and guidelines. J Bus Res. 2021;133(March):285-96.
10. Mongeon P, Paul-Hus A. The journal coverage of Web of Science and Scopus: a comparative analysis. Scientometrics. 2016;106(1):213-28.
11. Martín-Martín A, Orduna-Malea E, Thelwall M, Delgado López-Cózar E. Google Scholar, Web of Science, and Scopus: A systematic comparison of citations in 252 subject categories. J Informetr. 2018;12(4):1160-77.
12. Montazeri A, Mohammadi S, M. Hesari P, Ghaemi M, Riazi H, Sheikhi-Mobarakeh Z. Preliminary guideline for reporting bibliometric reviews of the biomedical literature (BIBLIO): a minimum requirement. Syst Rev. 2023;12(1):239.
13. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth Universal Definition of Myocardial Infarction (2018). J Am Coll Cardiol. 2018;72(18):2231-64.
14. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2018;39(2):119-77.
15. Collet J-P, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021;42(14):1289-367.
16. Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720-826.
17. Jespersen L, Hvelplund A, Abildstrom SZ, Pedersen F, Galatius S, Madsen JK, et al. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events. Eur Heart J. 2012;33(6):734-44.
18. Kunadian V, Chieffo A, Camici PG, Berry C, Escaned J, Maas AHEM, et al. An EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries in Collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders Internati. EuroIntervention. 2021;16(13):1049-69.
19. Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019;394(10204):1145-58.
20. Li H, Ge J. Cardiovascular diseases in China: Current status and future perspectives. IJC Heart Vasc. 2015; 6:25-31.
21. Lindahl B, Baron T, Erlinge D, Hadziosmanovic N, Nordenskjöld A, Gard A, et al. Medical Therapy for Secondary Prevention and Long-Term Outcome in Patients with Myocardial Infarction with Nonobstructive Coronary Artery Disease. Circulation. 2017;135(16):1481-9.
22. Beltrame JF, Crea F, Kaski JC, Ogawa H, Ong P, Sechtem U, et al. international standardization of diagnostic criteria for vasospastic angina. Eur Heart J. 2015;38(33): ehv351.
23. Abdu FA, Mohammed A-Q, Liu L, Xu Y, Che W. Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA): A Review of the Current Position. Cardiology. 2020;145(9):543-52.
24. Abdu FA, Alifu J, Mohammed A-Q, Liu L, Zhang W, Yin G, et al. The correlation of atherogenic index of plasma with non-obstructive CAD and unfavorable prognosis among patients diagnosed with MINOCA. Eur J Intern Med. 2024; 125:111-9.
25. Abdu FA, Liu L, Mohammed A-Q, Xu B, Yin G, Xu S, et al. Effect of Secondary Prevention Medication on the Prognosis in Patients with Myocardial Infarction with Nonobstructive Coronary Artery Disease. J Cardiovasc Pharmacol. 2020;76(6):678-83.
26. Scalone G, Niccoli G, Crea F. Editor’s Choice- Pathophysiology, diagnosis and management of MINOCA: an update. Eur Heart J Acute Cardiovasc Care. 2019;8(1):54-62.
27. Reynolds HR, Srichai MB, Iqbal SN, Slater JN, Mancini GBJ, Feit F, et al. Mechanisms of Myocardial Infarction in Women Without Angiographically Obstructive Coronary Artery Disease. Circulation. 2011;124(13):1414-25.
28. Montone RA, Niccoli G, Fracassi F, Russo M, Gurgoglione F, Cammà G, et al. Patients with acute myocardial infarction and non-obstructive coronary arteries: safety and prognostic relevance of invasive coronary provocative tests. Eur Heart J. 2017;39(2):91-8.
29. Reynolds HR, Maehara A, Kwong RY, Sedlak T, Saw J, Smilowitz NR, et al. Coronary Optical Coherence Tomography and Cardiac Magnetic Resonance Imaging to Determine Underlying Causes of Myocardial Infarction with Nonobstructive Coronary Arteries in Women. Circulation. 2021;143(7):624-40.
30. Gao J, Meng T, Li M, Du R, Ding J, Li A, et al. Global trends and frontiers in research on coronary microvascular dysfunction: a bibliometric analysis from 2002 to 2022. Eur J Med Res. 2022;27(1):233.
31. Gudenkauf B, Hays AG, Tamis‐Holland J, Trost J, Ambinder DI, Wu KC, et al. Role of Multimodality Imaging in the Assessment of Myocardial Infarction with Nonobstructive Coronary Arteries: Beyond Conventional Coronary Angiography. J Am Heart Assoc. 2022;11(1): e022787.
32. Niccoli G, Scalone G, Lerman A, Crea F. Coronary microvascular obstruction in acute myocardial infarction. Eur Heart J. 2016;37(13):1024-33.
2. Tamis-Holland JE, Jneid H, Reynolds HR, Agewall S, Brilakis ES, Brown TM, et al. Contemporary Diagnosis and Management of Patients with Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease: A Scientific Statement from the American Heart Association. Circulation. 2019;139(18): e891-908.
3. Pasupathy S, Air T, Dreyer RP, Tavella R, Beltrame JF. Systematic review of patients presenting with suspected myocardial infarction and nonobstructive coronary arteries. Circulation. 2015;131(10):861-70.
4. Reynolds HR, Maehara A, Kwong RY, Sedlak T, Saw J, Smilowitz NR, et al. Coronary Optical Coherence Tomography and Cardiac Magnetic Resonance Imaging to Determine Underlying Causes of Myocardial Infarction with Nonobstructive Coronary Arteries in Women. Circulation. 2021;143(7):624-40.
5. Tognola C, Maloberti A, Varrenti M, Mazzone P, Giannattasio C, Guarracini F. Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA): Current Insights into Pathophysiology, Diagnosis, and Management. Diagnostics. 2025;15(7):1-18.
6. Nordenskjöld AM, Baron T, Eggers KM, Jernberg T, Lindahl B. Predictors of adverse outcome in patients with myocardial infarction with non-obstructive coronary artery (MINOCA) disease. Int J Cardiol. 2018; 261:18-23.
7. Bairey Merz CN, Pepine CJ, Walsh MN, Fleg JL, Camici PG, Chilian WM, et al. Ischemia and No Obstructive Coronary Artery Disease (INOCA). Circulation. 2017;135(11):1075-92.
8. Pustjens TFS, Appelman Y, Damman P, ten Berg JM, Jukema JW, de Winter RJ, et al. Guidelines for the management of myocardial infarction/injury with non-obstructive coronary arteries (MINOCA): a position paper from the Dutch ACS working group. Neth Heart J. 2020;28(3):116-30.
9. Donthu N, Kumar S, Mukherjee D, Pandey N, Lim WM. How to conduct a bibliometric analysis: An overview and guidelines. J Bus Res. 2021;133(March):285-96.
10. Mongeon P, Paul-Hus A. The journal coverage of Web of Science and Scopus: a comparative analysis. Scientometrics. 2016;106(1):213-28.
11. Martín-Martín A, Orduna-Malea E, Thelwall M, Delgado López-Cózar E. Google Scholar, Web of Science, and Scopus: A systematic comparison of citations in 252 subject categories. J Informetr. 2018;12(4):1160-77.
12. Montazeri A, Mohammadi S, M. Hesari P, Ghaemi M, Riazi H, Sheikhi-Mobarakeh Z. Preliminary guideline for reporting bibliometric reviews of the biomedical literature (BIBLIO): a minimum requirement. Syst Rev. 2023;12(1):239.
13. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, et al. Fourth Universal Definition of Myocardial Infarction (2018). J Am Coll Cardiol. 2018;72(18):2231-64.
14. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, et al. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2018;39(2):119-77.
15. Collet J-P, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2021;42(14):1289-367.
16. Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, et al. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720-826.
17. Jespersen L, Hvelplund A, Abildstrom SZ, Pedersen F, Galatius S, Madsen JK, et al. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events. Eur Heart J. 2012;33(6):734-44.
18. Kunadian V, Chieffo A, Camici PG, Berry C, Escaned J, Maas AHEM, et al. An EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries in Collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders Internati. EuroIntervention. 2021;16(13):1049-69.
19. Zhou M, Wang H, Zeng X, Yin P, Zhu J, Chen W, et al. Mortality, morbidity, and risk factors in China and its provinces, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2019;394(10204):1145-58.
20. Li H, Ge J. Cardiovascular diseases in China: Current status and future perspectives. IJC Heart Vasc. 2015; 6:25-31.
21. Lindahl B, Baron T, Erlinge D, Hadziosmanovic N, Nordenskjöld A, Gard A, et al. Medical Therapy for Secondary Prevention and Long-Term Outcome in Patients with Myocardial Infarction with Nonobstructive Coronary Artery Disease. Circulation. 2017;135(16):1481-9.
22. Beltrame JF, Crea F, Kaski JC, Ogawa H, Ong P, Sechtem U, et al. international standardization of diagnostic criteria for vasospastic angina. Eur Heart J. 2015;38(33): ehv351.
23. Abdu FA, Mohammed A-Q, Liu L, Xu Y, Che W. Myocardial Infarction with Nonobstructive Coronary Arteries (MINOCA): A Review of the Current Position. Cardiology. 2020;145(9):543-52.
24. Abdu FA, Alifu J, Mohammed A-Q, Liu L, Zhang W, Yin G, et al. The correlation of atherogenic index of plasma with non-obstructive CAD and unfavorable prognosis among patients diagnosed with MINOCA. Eur J Intern Med. 2024; 125:111-9.
25. Abdu FA, Liu L, Mohammed A-Q, Xu B, Yin G, Xu S, et al. Effect of Secondary Prevention Medication on the Prognosis in Patients with Myocardial Infarction with Nonobstructive Coronary Artery Disease. J Cardiovasc Pharmacol. 2020;76(6):678-83.
26. Scalone G, Niccoli G, Crea F. Editor’s Choice- Pathophysiology, diagnosis and management of MINOCA: an update. Eur Heart J Acute Cardiovasc Care. 2019;8(1):54-62.
27. Reynolds HR, Srichai MB, Iqbal SN, Slater JN, Mancini GBJ, Feit F, et al. Mechanisms of Myocardial Infarction in Women Without Angiographically Obstructive Coronary Artery Disease. Circulation. 2011;124(13):1414-25.
28. Montone RA, Niccoli G, Fracassi F, Russo M, Gurgoglione F, Cammà G, et al. Patients with acute myocardial infarction and non-obstructive coronary arteries: safety and prognostic relevance of invasive coronary provocative tests. Eur Heart J. 2017;39(2):91-8.
29. Reynolds HR, Maehara A, Kwong RY, Sedlak T, Saw J, Smilowitz NR, et al. Coronary Optical Coherence Tomography and Cardiac Magnetic Resonance Imaging to Determine Underlying Causes of Myocardial Infarction with Nonobstructive Coronary Arteries in Women. Circulation. 2021;143(7):624-40.
30. Gao J, Meng T, Li M, Du R, Ding J, Li A, et al. Global trends and frontiers in research on coronary microvascular dysfunction: a bibliometric analysis from 2002 to 2022. Eur J Med Res. 2022;27(1):233.
31. Gudenkauf B, Hays AG, Tamis‐Holland J, Trost J, Ambinder DI, Wu KC, et al. Role of Multimodality Imaging in the Assessment of Myocardial Infarction with Nonobstructive Coronary Arteries: Beyond Conventional Coronary Angiography. J Am Heart Assoc. 2022;11(1): e022787.
32. Niccoli G, Scalone G, Lerman A, Crea F. Coronary microvascular obstruction in acute myocardial infarction. Eur Heart J. 2016;37(13):1024-33.
| Files | ||
| Issue | Vol 20 No 4 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| MINOCA Acute Coronary Syndrome Myocardial Infarction Nonobstructive Coronary Artery Disease Bibliometric Analysis | ||
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How to Cite
1.
Srimulyo T, Dwi Saputra A, Adji A, Komalasari I, Billah A, Saisa D, Her Oktaviano Y. Global Research Topics and Trends of Myocardial Infarction with Nonobstructive Coronary Arteries: A Bibliometric Analysis. Res Heart Yield Transl Med. 2025;20(4):294-309.
