Colchicine in Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): A Narrative Review
Gavin Agza Chandralifio1, Hendri Susilo2*
Abstract
Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA) is a heterogeneous clinical syndrome, accounting for 5–15% of myocardial infarction cases, characterized by myocardial injury in the absence of significant epicardial coronary obstruction. Unlike classical myocardial infarction caused by plaque rupture, MINOCA arises from diverse mechanisms, including coronary vasospasm, microvascular dysfunction, thromboembolism, spontaneous coronary artery dissection, Takotsubo cardiomyopathy, and myocarditis. Despite unobstructed coronary arteries, MINOCA carries substantial morbidity, recurrent cardiovascular events, and mortality, with inflammation playing a central role in its pathophysiology. Colchicine, a well-established anti-inflammatory agent, has emerged as a promising therapeutic option due to its ability to inhibit the NLRP3 inflammasome, modulate the AMPK/SIRT1 signaling pathway, and regulate neutrophil function, including chemotaxis, adhesion, and neutrophil extracellular trap formation. These mechanisms suppress pro-inflammatory cytokine release, reduce pyroptosis, and mitigate microvascular injury, ultimately limiting myocardial damage and improving cardiac function. While most clinical evidence derives from obstructive coronary syndromes, experimental and clinical studies suggest that colchicine’s anti-inflammatory and cardioprotective effects may extend to patients with MINOCA, particularly those with microvascular dysfunction or ongoing inflammation. This narrative review synthesizes current knowledge on MINOCA pathophysiology, elucidates the mechanistic basis for colchicine therapy, and highlights its potential role as a targeted anti-inflammatory intervention in this unique patient population.
Keywords
colchicine; inflammation; literature review; MINOCA
Cite This Article
Chandralifio, G. A., Susilo, H. (2025). Colchicine in Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): A Narrative Review. International Journal of Scientific Advances (IJSCIA), Volume 6| Issue 6: Nov – Dec 2025, Pages 1142-1147 URL: https://www.ijscia.com/wp-content/uploads/2025/12/Volume6-Issue6-Nov-Dec-No.987-1142-1147.pdf
Volume 6 | Issue 6: Nov – Dec 2025
