Pacheco Claudio Christine, Quesada Odayme, Pepine Carl J, Noel Bairey Merz C
Barbra Streisand Women's Heart Center, Cedars-Sinai Smidt Heart Institute, Los Angeles, California.
Division of Cardiology, University of Florida, Gainesville, Florida.
Clin Cardiol. 2018 Feb;41(2):185-193. doi: 10.1002/clc.22894. Epub 2018 Mar 2.
The syndromes of myocardial infarction/myocardial ischemia with No Obstructive Coronary Artery Disease (MINOCA/INOCA) are increasingly evident. A majority of these patients have coronary microvascular dysfunction. These patients have elevated risk for a cardiovascular event (including acute coronary syndrome, myocardial infarction, stroke, and repeated cardiovascular procedures) and appear to be at higher risk for development of heart failure with preserved ejection fraction. Terminology such as coronary artery disease or coronary heart disease is often synonymous with obstructive atherosclerosis in the clinician's mind, leaving one at a loss to recognize or explain the phenomenon of MINOCA and INOCA with elevated risk. We review the available literature regarding stable and unstable ischemic heart disease that suggests that use of the ischemic heart disease (IHD) terminology matters for women, and should facilitate recognition of risk to provide potential treatment targets and optimized health.
无阻塞性冠状动脉疾病的心肌梗死/心肌缺血综合征（MINOCA/INOCA）日益明显。这些患者中的大多数存在冠状动脉微血管功能障碍。这些患者发生心血管事件（包括急性冠状动脉综合征、心肌梗死、中风和重复的心血管手术）的风险升高，并且似乎发生射血分数保留的心力衰竭的风险更高。在临床医生的观念中，诸如冠状动脉疾病或冠心病等术语通常与阻塞性动脉粥样硬化同义，这使得人们难以识别或解释具有较高风险的MINOCA和INOCA现象。我们回顾了关于稳定型和不稳定型缺血性心脏病的现有文献，这些文献表明，缺血性心脏病（IHD）术语的使用对女性很重要，并且应有助于识别风险，以提供潜在的治疗靶点并优化健康状况。
