Key result
The management of ANOCA involves a four-step framework progressing from diagnosis and haemodynamic phenotyping to identifying mechanistic pathophysiology and implementing causal pharmacotherapy.
Outlines a four-step conceptual framework for the diagnosis, phenotyping, mechanistic understanding, and targeted pharmacotherapy of angina with non-obstructive coronary arteries (ANOCA).
There are four steps from: (1) diagnosis of ANOCA (by pain, ECG signs of ischaemia and angiographic exclusion of obstruction worthy of intervention) over (2) haemodynamic phenotyping (by adenosine and acetylcholine responsiveness in epicardial arteries and microvessels) and (3) mechanistic pathophysiology (by identification of causal mediators and mechanisms) to finally, (4) a causal pharmacotherapy (addressing the symptoms through effects on the pathophysiological mechanism).
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Heusch et al. (2025) conducted a review in Angina with non-obstructive coronary arteries (ANOCA). The management of ANOCA involves a four-step framework progressing from diagnosis and haemodynamic phenotyping to identifying mechanistic pathophysiology and implementing causal pharmacotherapy.
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