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.
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Funding
Dr. Pepine receives funding related to the topic from the National Institutes of Health (R01HL146158, WISE HFpEF https://clinicaltrials.gov/ct2/show/NCT02582021) and the US Department of Defense (W81XWH-17–2-0030, WARRIOR https://clinicaltrials.gov/ct2/show/NCT03417388).
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This article is part of the Topical Collection on Women and Ischemic Heart Disease
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Ya’Qoub, L., Elgendy, I.Y. & Pepine, C.J. Non-obstructive Plaque and Treatment of INOCA: More to Be Learned. Curr Atheroscler Rep 24, 681–687 (2022). https://doi.org/10.1007/s11883-022-01044-4
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DOI: https://doi.org/10.1007/s11883-022-01044-4