Key result
Invasive functional testing in patients with non-obstructive coronary artery disease allows for accurate diagnosis of vasospastic or microvascular angina and guides optimal stratified medical therapy.
Why the study?
In half of cases during coronary angiography, obstructive coronary lesions are not detected in chronic coronary artery disease, leading to repeated tests without correct diagnosis.
This review highlights the importance of invasive and non-invasive diagnostic testing to differentiate vasospastic and microvascular angina in patients with INOCA to guide targeted medical therapy.
In half of cases during coronary angiography (CAG), obstructive coronary artery lesions aren’t detected in patients with chronic coronary artery disease. Such patients mostly have vasospastic angina (VSA) and/or microvascular angina (MVA). These patients can be performed repeated diagnostic tests, including selective coronary angiography, but as a result they are never diagnosed correctly. This review presents modern pathogenetic mechanisms for the development and methods of diagnosing of ischemia with non-obstructive coronary artery disease. It also highlights choice of treatment tactics in accordance with the identified pathophysiological mechanism for the development of chronic coronary artery disease.
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Utegenov et al. (2023) conducted a review in Coronary heart disease without obstructive atherosclerotic lesions (vasospastic and microvascular angina). Invasive coronary function testing and stratified medical therapy was evaluated. Invasive functional testing in patients with non-obstructive coronary artery disease allows for accurate diagnosis of vasospastic or microvascular angina and guides optimal stratified medical therapy.
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