Polyak Alexander, Wei Janet, Gulati Martha, Merz Noel Bairey
Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Am Heart J Plus. 2024 Jan;37. doi: 10.1016/j.ahjo.2023.100352. Epub 2023 Dec 6.
Ischemia with no obstructive coronary arteries (INOCA) is defined as patients with evidence of myocardial ischemia without obstructive coronary artery disease. About 3-4 million people in the United States have INOCA, more commonly affecting women, and carries adverse morbidity, mortality, and relatively high healthcare costs. The pathophysiology of INOCA appears to be multi-factorial with a variety of contributing mechanisms. Diagnosis of INOCA is suggested by non-invasive or invasive testing consistent with myocardial ischemia. Due to the high prevalence of coronary risk factors and atherosclerosis in the INOCA population, current treatment strategies target angina, coronary atherosclerosis, and atherosclerotic risk factors, as well as burgeoning treatment of coronary microvascular dysfunction (CMD). Ongoing clinical trials are assessing different options.
无阻塞性冠状动脉的心肌缺血（INOCA）被定义为有心肌缺血证据但无阻塞性冠状动脉疾病的患者。在美国，约有300万至400万人患有INOCA，女性更为常见，且会带来不良发病率、死亡率以及相对较高的医疗成本。INOCA的病理生理学似乎是多因素的，有多种促成机制。INOCA的诊断通过与心肌缺血一致的非侵入性或侵入性检测来提示。由于INOCA人群中冠状动脉危险因素和动脉粥样硬化的高患病率，当前的治疗策略针对心绞痛、冠状动脉粥样硬化和动脉粥样硬化危险因素，以及新兴的冠状动脉微血管功能障碍（CMD）治疗。正在进行的临床试验正在评估不同的选择。
