Key result
Coronary microvascular disease frequently coexists with macrovascular atherosclerosis and represents a novel therapeutic target.
Why the study?
Coronary microvascular disease is prevalent across diverse cardiovascular risk factors and increases adverse event risk, with most patients also harboring macrovessel atherosclerosis that impacts prognosis and management.
This state-of-the-art review provides an updated framework for understanding, diagnosing, and treating coronary microvascular disease, highlighting its frequent coexistence with macrovascular atherosclerosis.
May support integrated CMD assessment in CAD; leaves open whether targeted interventions improve outcomes.
Coronary microvascular disease (CMD) refers to the subset of disorders affecting the structure and function of the coronary microcirculation, is prevalent in patients across a broad spectrum of cardiovascular risk factors, and is associated with an increased risk of adverse events. Contemporary evidence supports that most patients with CMD also have macrovessel atherosclerosis, which has important implications for their prognosis and management. In this state-of-the-art review, the authors summarize the pathophysiology of CMD, provide an update of diagnostic testing strategies, and classify CMD into phenotypes according to severity and coexistence with atherosclerosis. They examine emerging data highlighting the significance of CMD in specific populations, including obesity and insulin resistance, myocardial injury and heart failure with preserved ejection fraction, and nonobstructive and obstructive coronary artery disease. Finally, they discuss the role of CMD as a potential target for novel interventions beyond conventional approaches, representing a new frontier in cardiovascular disease reduction.
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Taqueti et al. (2018) conducted a review in Coronary microvascular disease. Coronary microvascular disease often coexists with macrovessel atherosclerosis and represents a potential target for novel interventions beyond conventional approaches to reduce cardiovascular disease.
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