Casolo Giancarlo, Gabrielli Domenico, Colivicchi Furio, Murrone Adriano, Grosseto Daniele, Gulizia Michele Massimo, Di Fusco Stefania, Domenicucci Stefano, Scotto di Uccio Fortunato, Di Tano Giuseppe, Orso Francesco, Grippo Gabriele, Abrignani Maurizio, Valente Serafina, Corda Marco
Cardiology Department, Ospedale Versilia, Lido di Camaiore (LU), Via Aurelia 335, 55041 Lido di Camaiore, Italy.
Cardiology-CCU Department, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy.
Eur Heart J Suppl. 2021 Aug 26;23(Suppl C):C164-C175. doi: 10.1093/eurheartj/suab072. eCollection 2021 Aug.
Atherosclerosis often affects the coronary arterial tree. Frequently the disease does not translate in significant narrowing of the vessels, thus determining only a non-obstructive disease. This condition that is described as non-obstructive coronary artery disease (NobsCAD) should be distinguished from the absence of disease (i.e. smooth coronary arteries) as it carries a specific prognostic value. The detection and reporting of NobsCAD should prompt preventive measures that can be individualized upon the degree of the underlying burden of disease. The accompanying clinical condition, the other cardiovascular risk factors present, and the description of the severity and extent of NobsCAD should provide the framework for an individualized treatment that should also consider the best available scientific evidence and guidelines. The description of NobsCAD represents important information to be collected whenever a coronary angiogram (both invasive and non-invasive) is performed. Treating the patient according to the presence and extent of NobsCAD offers prognostic benefits well beyond those offered by considering only the traditional cardiovascular risk factors. In order to reach this goal, NobsCAD should not be confused with the absence of coronary atherosclerosis or even ignored when detected as if it was a trivial information to provide.
动脉粥样硬化常累及冠状动脉树。该病通常不会导致血管显著狭窄，因此仅表现为非阻塞性疾病。这种被描述为非阻塞性冠状动脉疾病（NobsCAD）的情况应与无疾病状态（即冠状动脉光滑）相区分，因为它具有特定的预后价值。NobsCAD的检测和报告应促使采取可根据潜在疾病负担程度个体化的预防措施。伴随的临床状况、存在的其他心血管危险因素以及NobsCAD严重程度和范围的描述，应为个体化治疗提供框架，该治疗还应考虑现有最佳科学证据和指南。NobsCAD的描述是在进行冠状动脉造影（包括有创和无创）时应收集的重要信息。根据NobsCAD的存在和范围治疗患者所带来的预后益处远超过仅考虑传统心血管危险因素所带来的益处。为了实现这一目标，不应将NobsCAD与无冠状动脉粥样硬化相混淆，甚至在检测到它时也不应忽视，仿佛它是一个无关紧要的信息。
