Suda Akira, Takahashi Jun, Beltrame John F, Berry Colin, Camici Paolo G, Crea Filippo, Escaned Javier, Ford Tom, Carlos Kaski Juan, Kiyooka Takahiko, Metha Puja K, Ong Peter, Ozaki Yukio, Pepine Carl, Rimoldi Ornella, Safdar Basmah, Sechtem Udo, Tsujita Kenichi, Yii Eric, Noel Bairey Merz C, Shimokawa Hiroaki
Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
The Discipline of Medicine, University of Adelaide, Basil Hetzel Institute, Central Adelaide Local Health Network, Adelaide, South Australia, Australia.
Int J Cardiol Heart Vasc. 2020 Sep 11;31:100630. doi: 10.1016/j.ijcha.2020.100630. eCollection 2020 Dec.
Patients with signs and symptoms of myocardial ischemia and non-obstructive coronary artery disease (CAD) frequently have coronary functional abnormalities, including coronary microvascular dysfunction. Those with the latter are grouped under the term "microvascular angina" (MVA). Although diagnostic criteria exist for MVA, as recently proposed by our COVADIS (COronary VAsomotor Disorders International Study) group and the condition has been increasingly recognized in clinical practice, the clinical characteristics and long-term prognosis of MVA patients in the current era remain to be fully elucidated.
In the present study, we aimed to prospectively assess the clinical characteristics and long-term prognosis of MVA subjects in the current era in an international, multicenter, observational, and prospective registry study.
A total of 15 medical centers across 7 countries (USA, UK, Germany, Spain, Italy, Australia, and Japan) enrolled subjects fulfilling the COVADIS diagnostic criteria for MVA as follows; (1) signs and/or symptoms of myocardial ischemia, (2) absence of obstructive CAD, and (3) objective evidence of myocardial ischemia and/or coronary microvascular dysfunction. The primary endpoint was the composite of major cardiovascular events (MACE), including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, hospitalization due to heart failure or unstable angina. Between July 2015 and December 2018, a total of 706 subjects with MVA (M/F 256/450, 61.1 ± 11.8 [SD] yrs.) were registered. Subjects will be followed for at least 1 year.
The present study will provide important information regarding the clinical characteristics, management, and long-term prognosis of MVA patients in the current era.
有心肌缺血体征和症状且患有非阻塞性冠状动脉疾病(CAD)的患者常伴有冠状动脉功能异常,包括冠状动脉微血管功能障碍。后者被归类为“微血管性心绞痛”(MVA)。尽管我们的COVADIS(冠状动脉血管舒缩障碍国际研究)小组最近提出了MVA的诊断标准,且该病症在临床实践中已得到越来越多的认识,但当前时代MVA患者的临床特征和长期预后仍有待充分阐明。
在本研究中,我们旨在通过一项国际、多中心、观察性和前瞻性注册研究,前瞻性评估当前时代MVA患者的临床特征和长期预后。
来自7个国家(美国、英国、德国、西班牙、意大利、澳大利亚和日本)的15个医学中心招募了符合以下COVADIS MVA诊断标准的受试者:(1)心肌缺血的体征和/或症状,(2)无阻塞性CAD,(3)心肌缺血和/或冠状动脉微血管功能障碍的客观证据。主要终点是主要心血管事件(MACE)的复合终点,包括心血管死亡、非致命性心肌梗死、非致命性中风、因心力衰竭或不稳定型心绞痛住院。在2015年7月至2018年12月期间,共登记了706例MVA患者(男/女256/450,年龄61.1±11.8[标准差]岁)。受试者将被随访至少1年。
本研究将提供有关当前时代MVA患者临床特征、管理和长期预后的重要信息。