Hosadurg Nisha, Watts Kelsey, Wang Shuo, Wingerter Kelly E, Taylor Angela M, Villines Todd C, Patel Amit R, Bourque Jamieson M, Lindner Jonathan R, Kramer Christopher M, Sharma Garima, Rodriguez Lozano Patricia F
Cardiovascular Division, Department of Medicine, University of Virginia Health, Charlottesville, Virginia, USA.
Center for Public Health Genomics, University of Virginia School of Medicine, Charlottesville, Virginia, USA.
JACC Adv. 2024 Jul 4;3(8):101074. doi: 10.1016/j.jacadv.2024.101074. eCollection 2024 Aug.
Women are disproportionately affected by symptoms of angina with nonobstructive coronary arteries (ANOCA) which is associated with significant mortality and economic impact. Although distinct endotypes of ANOCA have been defined, it is underdiagnosed and is often incompletely characterized when identified. Patients are often unresponsive to traditional therapeutic options, which are typically antianginal, and the current ability to guide treatment modification by specific pathways is limited. Studies have associated specific genetic loci, transcriptomic features, and biomarkers with ANOCA. Such panomic data, in combination with known imaging and invasive diagnostic techniques, should be utilized to define more precise pathophysiologic subtypes of ANOCA in women, which will in turn help to identify targeted, effective therapies. A precision medicine-based approach to managing ANOCA incorporating these techniques in women has the potential to significantly improve their clinical care.
女性受非阻塞性冠状动脉性心绞痛（ANOCA）症状的影响尤为严重，该疾病与显著的死亡率和经济影响相关。尽管已定义了ANOCA的不同内型，但它仍未得到充分诊断，且确诊时往往特征描述不完整。患者通常对传统治疗方案（通常为抗心绞痛药物）无反应，目前通过特定途径指导治疗调整的能力有限。研究已将特定的基因位点、转录组特征和生物标志物与ANOCA相关联。这些全景数据，结合已知的成像和侵入性诊断技术，应用于定义女性ANOCA更精确的病理生理亚型，这反过来将有助于确定有针对性的有效治疗方法。在女性中采用基于精准医学的方法管理ANOCA并结合这些技术，有可能显著改善她们的临床护理。
