Adelaide Medical School, University of Adelaide, Queen Elizabeth Hospital Campus, Woodville South, Adelaide, SA, Australia
Department of Cardiology, Central Adelaide Local Health Network, SA Health, Adelaide, SA, Australia.
BMJ. 2021 Nov 26;375:e060602. doi: 10.1136/bmj-2021-060602.
Up to half of patients undergoing elective coronary angiography for the investigation of chest pain do not present with evidence of obstructive coronary artery disease. These patients are often discharged with a diagnosis of non-cardiac chest pain, yet many could have an ischaemic basis for their symptoms. This type of ischaemic chest pain in the absence of obstructive coronary artery disease is referred to as INOCA (ischaemia with non-obstructive coronary arteries). This comprehensive review of INOCA management looks at why these patients require treatment, who requires treatment based on diagnostic evaluation, what clinical treatment targets should be considered, how to treat patients using a personalised medicine approach, when to initiate treatment, and where future research is progressing.
多达一半接受选择性冠状动脉造影检查胸痛的患者没有出现阻塞性冠状动脉疾病的证据。这些患者通常被诊断为非心源性胸痛出院，但他们的症状可能有缺血基础。在没有阻塞性冠状动脉疾病的情况下，这种类型的缺血性胸痛被称为INOCA（非阻塞性冠状动脉疾病引起的缺血）。这篇关于 INOCA 管理的综合综述探讨了这些患者为何需要治疗、根据诊断评估哪些患者需要治疗、应考虑哪些临床治疗目标、如何采用个体化医学方法治疗患者、何时开始治疗以及未来研究的进展方向。
