Gulati Martha, Khan Najah, George Maria, Berry Colin, Chieffo Alaide, Camici Paolo G, Crea Filippo, Kaski Juan-Carlos, Marzilli Mario, Merz C Noel Bairey
Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA.
Houston Methodist Hospital, Houston, TX, USA.
Int J Cardiol. 2023 Jan 15;371:28-39. doi: 10.1016/j.ijcard.2022.09.047. Epub 2022 Sep 23.
There is limited information available regarding evidence of ischemia with no obstructive coronary arteries (INOCA) and quality of life.
To determine associations between INOCA and self-reported physical, social, and mental health.
We conducted a survey of all members (n = 1579) of the INOCA International patient support group. Current self-reported diagnosis and health measures were collected. Functional capacity was retrospectively estimated using the Duke Activity Status Index (DASI), assessing levels of activities performed prior and after symptom onset.
A total of 297 (20.8% response rate, 91% women) reported symptoms of chest pain, pressure, or discomfort in 92.9%. Overall, 34.4% were living with symptoms for ≥3 years before an INOCA diagnosis, and 77.8% were told their symptoms were not cardiac. Estimated functional capacity was higher prior to compared to after symptom onset (8.6 ± 1.8 METs vs 5.6 ± 1.8 METs; P < 0.0001). Most respondents reported an adverse impact of symptoms on their home life (80.5%), social life (80.1%), mental health (70.4%), outlook on life (69.7%), sex life (55.9%), and their partner/spouse relationship (53.9%), while approximately three-quarters reduced their work hours or stopped work completely, 47.5% retired early, and 38.4% applied for disability.
INOCA symptoms are associated with adverse physical, mental and social health quality of life. Increased patient awareness, physician recognition and diagnosis, and clinical trials are needed to develop evidence-based guidelines for this increasingly recognized cardiovascular disorder.
关于无阻塞性冠状动脉的心肌缺血(INOCA)证据及生活质量的可用信息有限。
确定INOCA与自我报告的身体、社交和心理健康之间的关联。
我们对INOCA国际患者支持小组的所有成员(n = 1579)进行了一项调查。收集了当前自我报告的诊断和健康指标。使用杜克活动状态指数(DASI)回顾性评估功能能力,评估症状发作前后进行的活动水平。
共有297人(回复率20.8%,91%为女性)报告有胸痛、压迫感或不适症状,占92.9%。总体而言,34.4%的人在INOCA诊断前有症状≥3年,77.8%的人被告知其症状并非心脏问题。症状发作前的估计功能能力高于发作后(8.6±1.8代谢当量对5.6±1.8代谢当量;P<0.0001)。大多数受访者报告症状对其家庭生活(80.5%)、社交生活(80.1%)、心理健康(70.4%)、人生观(69.7%)、性生活(55.9%)及其伴侣/配偶关系(53.9%)有不利影响,约四分之三的人减少了工作时间或完全停止工作,47.5%的人提前退休,38.4%的人申请了残疾。
INOCA症状与不良的身体、心理和社会生活质量相关。需要提高患者意识、医生的识别和诊断能力以及开展临床试验,以制定针对这种日益被认可的心血管疾病的循证指南。