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Mehta PK, Quesada O, Al-Badri A, et al. Ischemia and no obstructive coronary arteries in patients with stable ischemic heart disease. Int J Cardiol. 2021;348:1-8doi: 10.1016/j.ijcard.2021.12.013.
Mehta, P. K., Quesada, O., Al-Badri, A., Fleg, J. L., Volgman, A. S., Pepine, C. J., Merz, C. N. B., & Shaw, L. J. (2022). Ischemia and no obstructive coronary arteries in patients with stable ischemic heart disease. International journal of cardiology, 3481-8. https://doi.org/10.1016/j.ijcard.2021.12.013
Mehta, Puja K, et al. "Ischemia and no obstructive coronary arteries in patients with stable ischemic heart disease." International journal of cardiology vol. 348 (2022): 1-8. doi: https://doi.org/10.1016/j.ijcard.2021.12.013
Mehta PK, Quesada O, Al-Badri A, Fleg JL, Volgman AS, Pepine CJ, Merz CNB, Shaw LJ. Ischemia and no obstructive coronary arteries in patients with stable ischemic heart disease. Int J Cardiol. 2022 Feb 01;348:1-8. doi: 10.1016/j.ijcard.2021.12.013. Epub 2021 Dec 11. PMID: 34902504.
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Int J Cardiol. 2022 Feb 01;348:1-8. doi: 10.1016/j.ijcard.2021.12.013. Epub 2021 Dec 11.

Ischemia and no obstructive coronary arteries in patients with stable ischemic heart disease.

International journal of cardiology

Puja K Mehta, Odayme Quesada, Ahmed Al-Badri, Jerome L Fleg, Annabelle Santos Volgman, Carl J Pepine, C Noel Bairey Merz, Leslee J Shaw

Affiliations

  1. Emory Women's Heart Center, Division of Cardiology, Emory University, Atlanta, GA, United States of America. Electronic address: [email protected].
  2. Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, United States of America.
  3. Emory Women's Heart Center, Division of Cardiology, Emory University, Atlanta, GA, United States of America.
  4. Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD, United States of America.
  5. Section of Cardiology, Rush University Medical Center, Chicago, IL, United States of America.
  6. Division of Cardiology, University of Florida, Gainesville, FL, United States of America.
  7. Department of Radiology, Weill-Cornell Medical College, New York, NY, United States of America.

PMID: 34902504 DOI: 10.1016/j.ijcard.2021.12.013

Abstract

A large proportion of patients with suspected obstructive coronary artery disease (CAD) is found to have ischemia with no obstructive coronary artery disease (INOCA). Based on current evidence, these patients are at increased risk of adverse cardiovascular events, even though they have no obstructive CAD. Importantly, INOCA is associated with recurrent clinical presentations with chest pain, impaired functional capacity, reduced health-related quality of life, and high healthcare costs. Underlying coronary microvascular dysfunction (CMD), through endothelium-dependent and independent mechanisms contribute to these adverse outcomes in INOCA. While non-invasive and invasive diagnostic testing has typically focused on identification of obstructive CAD in symptomatic patients, functional testing to detect coronary epicardial and microvascular dysfunction should be considered in those with INOCA who have persistent angina. Current diagnostic methods to clarify functional abnormalities and treatment strategies for epicardial and/or microvascular dysfunction in INOCA are reviewed.

Copyright © 2021 Elsevier B.V. All rights reserved.

Keywords: Atherosclerosis; Coronary artery disease; Functional imaging; Ischemic heart disease

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