INOCA and MINOCA: Are Women's Heart Centres the Answer to Understanding and Management of These Increasing Populations of Women (and Men)?
INOCA and MINOCA: Are Women's Heart Centres the Answer to Understanding and Management of These Increasing Populations of Women (and Men)?
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INOCA 和 MINOCA：女性心脏中心是理解和管理这些不断增加的女性（和男性）人口的答案吗？
DOI：
10.1016/j.cjca.2022.06.016
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
BaireyMerz,CNoel
中科院分区：
文献类型：
--
作者：
Pacheco,Christine;Luu,Judy;Mehta,PujaK;Wei,Janet;Gulati,Martha;BaireyMerz,CNoel
心血管疾病（CVD）仍然是妇女发病率和死亡率的主要原因，这些妇女诊断不足，治疗不足，以及对主要影响她们的心脏病的预防，诊断和治疗研究不足（1）。值得注意的是，与男性相比，中年女性心血管疾病死亡率的下降已经停滞（1），这表明可能需要性别特异性方法。无阻塞性冠状动脉疾病（INOCA）的缺血可能会影响高达62%因疑似心绞痛而接受冠状动脉造影的女性，其中45-65岁的中年女性患病率更高（2）。基础病理生理学包括冠状动脉微血管功能障碍、冠状动脉内皮功能障碍和/或心外膜血管痉挛（2）。无阻塞性冠状动脉疾病（MINOCA）的心肌梗死（MI），定义为临床MI证据和无阻塞性CAD（病变< 50%），占MI的6%（3），在女性中更常见。MINOCA的常见潜在原因包括潜在斑块破裂、心外膜冠状动脉血管痉挛或隐匿性微血栓或自发性冠状动脉夹层。(2)虽然历史上被忽视，但INOCA和MINOCA都与不良结局相关（2），最近的文献有助于提高认识（4），命名共识（5，6），以及潜在地改善诊断检查（2）和治疗（2）。鉴于女性占INOCA和MINOCA诊断患者的大多数，北美关于这些临床实体的诊断，治疗和随访的临床专业知识集中在专门的妇女心脏中心（WHC），其概念是改善患者的预后，并解决知识差距。未来一年
Cardiovascular disease (CVD) continues to be a leading cause of morbidity and mortality in women who have been underdiagnosed, undertreated and under researched concerning prevention, diagnosis and treatment of cardiac conditions that predominantly affect them (1). Notably, declines in CVD death rates have stalled in mid-life women compared to men (1), suggesting sex-specific approaches may be needed. Ischemia with no obstructive coronary artery disease (INOCA), may affect up to 62% of women undergoing coronary angiography for suspected angina, with a higher prevalence in mid-life women aged 45-65 years (2). The underlying pathophysiology includes coronary microvascular dysfunction, coronary endothelial dysfunction and/or epicardial vasospasm (2). Myocardial infarction (MI) with no obstructive coronary artery disease (MINOCA), defined as evidence of clinical MI and absence of obstructive CAD (< 50% lesion), accounts for 6% of MI (3) and is more frequently diagnosed in women. Common underlying causes of MINOCA include underlying plaque disruption, epicardial coronary vasospasm or occult microthrombi or spontaneous coronary artery dissection.(2) Although historically overlooked, both INOCA and MINOCA are associated with adverse outcomes (2), and recent literature has contributed to increasing recognition (4), consensus on nomenclature (5, 6), as well as potentially improving diagnostic work-up (2) and therapy (2). Given that women represent the majority of patients diagnosed with INOCA and MINOCA, clinical expertise in North America regarding diagnosis, treatment and follow-up of these clinical entities, has been centered in specialized Women’s Heart Centres (WHC), with the concept to improve patient outcomes, as well address knowledge gaps. In One Year Prospective
影响因子：
39.3
作者：
Beltrame, John F.;Crea, Filippo;Merz, C. Noel Bairey
通讯作者：
Merz, C. Noel Bairey