Key result
Comprehensive review outlines diagnostic evaluation and personalized treatment targets for INOCA.
Why the study?
Many patients undergoing coronary angiography for chest pain have no obstructive coronary disease and are often discharged with non-cardiac diagnoses despite potential ischaemic symptoms.
This comprehensive review outlines the diagnostic evaluation, clinical targets, and personalized treatment approaches for patients with ischemia and non-obstructive coronary arteries (INOCA).
May inform INOCA evaluation and targets in practice; leaves open need for RCTs validating personalized approaches.
Up to half of patients undergoing elective coronary angiography for the investigation of chest pain do not present with evidence of obstructive coronary artery disease. These patients are often discharged with a diagnosis of non-cardiac chest pain, yet many could have an ischaemic basis for their symptoms. This type of ischaemic chest pain in the absence of obstructive coronary artery disease is referred to as INOCA (ischaemia with non-obstructive coronary arteries). This comprehensive review of INOCA management looks at why these patients require treatment, who requires treatment based on diagnostic evaluation, what clinical treatment targets should be considered, how to treat patients using a personalised medicine approach, when to initiate treatment, and where future research is progressing.
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Beltrame et al. (2021) conducted a review in Ischaemia with non-obstructive coronary arteries (INOCA). INOCA management was evaluated. A comprehensive review of INOCA management outlines diagnostic evaluation, clinical treatment targets, and personalized medicine approaches for patients without obstructive coronary artery disease.
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