Non-obstructive Plaque and Treatment of INOCA: More to Be Learned.

Non-obstructive Plaque and Treatment of INOCA: More to Be Learned.
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非阻塞性斑块和INOCA的治疗:更多的了解。

DOI:
10.1007/s11883-022-01044-4
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发表时间:
2022-09
影响因子:
5.8
通讯作者:
Pepine, Carl J.
Pepine, Carl J.
中科院分区:
医学2区
文献类型:
--
作者:
Ya'Qoub, Lina;Elgendy, Islam Y.;Pepine, Carl J.

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评估胸痛的患者中有相当大比例是缺血合并非阻塞性冠状动脉疾病(INOCA)。研究表明,INOCA与主要心脏不良事件的风险增加和卫生保健系统的重大负担有关。虽然缺乏关于INOCA管理的科学证据,但CorMicA试验表明,基于INOCA类型的分层药物治疗改善了患者的症状和生活质量。有多个正在进行的试验,包括妇女缺血试验以减少非阻塞性冠状动脉疾病事件(WARRIOR试验),评估强化药物治疗与常规护理对这一日益被认可的临床实体的益处。在这篇综述中,我们讨论了INOCA的定义,流行病学和危险因素,病理生理和管理,以及目前的知识差距和正在进行的临床试验。
A significant proportion of patients evaluated for chest pain have ischemia with non-obstructive coronary artery disease (INOCA). Studies have shown INOCA is associated with increased risk of major adverse cardiac events and significant burden on the health care system. While there is scarce scientific evidence on management of INOCA, the CorMicA trial showed that stratified medical therapy based on the type of INOCA improved patients’ symptoms and quality of life. There are multiple ongoing trials, including Women’s IschemiA Trial to Reduce Events in Non-ObstRuctIve CORonary Artery Disease (WARRIOR trial), assessing the benefit of intensive medical therapy versus usual care for this increasingly recognized clinical entity. In this review, we discuss the definition of INOCA, epidemiology and risk factors, pathophysiology, and management as well as the current knowledge gaps and ongoing clinical trials in this arena.
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