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

Lina Ya’Qoub; Islam Y. Elgendy; Carl J. Pepine

doi:10.1007/s11883-022-01044-4

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

Lina Ya’Qoub
, Islam Y. Elgendy
, Carl J. Pepine

Research output: Contribution to journal › Review article › peer-review

6 Scopus citations

Abstract

Purpose of Review: 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. Recent Findings: 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. Summary: 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.

Original language	English
Pages (from-to)	681-687
Number of pages	7
Journal	Current Atherosclerosis Reports
Volume	24
Issue number	9
DOIs	https://doi.org/10.1007/s11883-022-01044-4
State	Published - Sep 2022

Bibliographical note

Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Funding

Funders	Funder number
National Institutes of Health (NIH)
U.S. Department of Defense	W81XWH-17-2-0030
National Heart, Lung, and Blood Institute (NHLBI)	R01HL146158
Office of Extramural Research, National Institutes of Health
Office of Research Infrastructure Programs, National Institutes of Health

Keywords

Angina
Ischemia
Ischemia with non-obstructive coronary arteries
Microvascular dysfunction
Vasospastic angina

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

Access to Document

10.1007/s11883-022-01044-4

Cite this

@article{7c95847f046c44fba4962f47a526266f,

title = "Non-obstructive Plaque and Treatment of INOCA: More to Be Learned",

abstract = "Purpose of Review: 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. Recent Findings: 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{\textquoteright} symptoms and quality of life. There are multiple ongoing trials, including Women{\textquoteright}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. Summary: 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.",

keywords = "Angina, Ischemia, Ischemia with non-obstructive coronary arteries, Microvascular dysfunction, Vasospastic angina",

author = "Lina Ya{\textquoteright}Qoub and Elgendy, \{Islam Y.\} and Pepine, \{Carl J.\}",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2022",

month = sep,

doi = "10.1007/s11883-022-01044-4",

language = "English",

volume = "24",

pages = "681--687",

number = "9",

}

TY - JOUR

T1 - Non-obstructive Plaque and Treatment of INOCA

T2 - More to Be Learned

AU - Ya’Qoub, Lina

AU - Elgendy, Islam Y.

AU - Pepine, Carl J.

PY - 2022/9

Y1 - 2022/9

N2 - Purpose of Review: 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. Recent Findings: 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. Summary: 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.

AB - Purpose of Review: 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. Recent Findings: 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. Summary: 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.

KW - Angina

KW - Ischemia

KW - Ischemia with non-obstructive coronary arteries

KW - Microvascular dysfunction

KW - Vasospastic angina

UR - https://www.scopus.com/pages/publications/85133344386

UR - https://www.scopus.com/pages/publications/85133344386#tab=citedBy

U2 - 10.1007/s11883-022-01044-4

DO - 10.1007/s11883-022-01044-4

M3 - Review article

C2 - 35781776

AN - SCOPUS:85133344386

SN - 1523-3804

VL - 24

SP - 681

EP - 687

JO - Current Atherosclerosis Reports

JF - Current Atherosclerosis Reports

IS - 9

ER -

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

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this