The Role of Calcium Channel Blockers as Non‑Antiplatelet Therapy in MINOCA Patients: A Review of Current Clinical Evidence
Carissa Adelia Putri1, Hendri Susilo2*
Abstract
Myocardial infarction with non-obstructive coronary arteries (MINOCA) represents a heterogeneous clinical entity with diverse underlying pathophysiological mechanisms. Recent evidence has demonstrated that MINOCA accounts for approximately 2.7% to 15% of acute myocardial infarction presentations, particularly affecting younger patients and women with significant long-term morbidity and mortality. While dual antiplatelet therapy has traditionally been the cornerstone of acute coronary syndrome management, emerging data question the efficacy of antiplatelet agents in MINOCA given the heterogeneous nature of underlying etiologies, many of which do not involve platelet-mediated thrombosis. Calcium channel blockers (CCBs), as non-antiplatelet agents, represent a promising alternative therapeutic strategy, particularly in MINOCA phenotypes characterized by epicardial coronary vasospasm and coronary microvascular dysfunction. This review synthesizes current evidence on the mechanism of action of CCBs in the context of MINOCA pathophysiology, examines existing clinical trials evaluating CCB efficacy in MINOCA populations, and discusses potential sex- and age-specific considerations in CCB therapy. CCBs show considerable potential as first-line therapy for vasospasm-mediated MINOCA and warrant further investigation in adequately powered randomized controlled trials.
Keywords
calcium channel blockers; coronary vasospasm; microvascular dysfunction; MINOCA
Cite This Article
Putri, C. A., Susilo, H. (2025). The Role of Calcium Channel Blockers as Non‑Antiplatelet Therapy in MINOCA Patients: A Review of Current Clinical Evidence. International Journal of Scientific Advances (IJSCIA), Volume 6| Issue 6: Nov – Dec 2025, Pages 1135-1141 URL: https://www.ijscia.com/wp-content/uploads/2025/12/Volume6-Issue6-Nov-Dec-No.986-1135-1141.pdf
Volume 6 | Issue 6: Nov – Dec 2025
