This review provides a systematic approach to the diagnostic evaluation and tailored therapeutic management of patients with ischemia and no obstructive coronary arteries (INOCA).
This review provides a systematic approach to the diagnostic evaluation and tailored therapeutic management of patients with INOCA, a condition associated with increased risk of adverse outcomes and high healthcare costs.
Up to 65% of women and approximately 30% of men have ischemia with no obstructive coronary artery disease (CAD; commonly known as INOCA) on invasive coronary angiography performed for stable angina. INOCA can be due to coronary microvascular dysfunction or coronary vasospasm. Despite the absence of obstructive CAD, those with INOCA have an increased risk of all-cause mortality and adverse outcomes, including recurrent angina and cardiovascular events. These patients often undergo repeat testing, including cardiac catheterization, resulting in lifetime healthcare costs that rival those for obstructive CAD. Patients with INOCA often remain undiagnosed and untreated. This review discusses the symptoms and prognosis of INOCA, offers a systematic approach to the diagnostic evaluation of these patients, and summarizes therapeutic management, including tailored therapy according to underlying pathophysiological mechanisms.
Bastiany et al. (Wed,) conducted a review in Ischemia With No Obstructive Coronary Arteries (INOCA). Diagnostic evaluation and tailored therapy was evaluated. This review provides a systematic approach to the diagnostic evaluation and tailored therapeutic management of patients with ischemia and no obstructive coronary arteries (INOCA).