Myocardial infarction with non-obstructive coronary arteries (MINOCA) at coronary angiography (CAG) (stenosis<50%) is relatively common, and about 1% to 15 % of the prevalence was reported [1–3]. MINOCA is not a benign entity, the all-cause mortality rate in MINOCA patients at 1 year is 4.7% [4], and approximately 23.9% of MINOCA patients experienced a major adverse cardiac event (MACE) during four years of follow-up [5]. MINOCA is a heterogeneous clinical entity with multiple potential aetiologies leading to management inconsistency, of which coronary microvascular dysfunction (CMD) was suggested as a potential cause contributing in the pathogenesis of MINOCA [2,6–8].
