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心绞痛与非阻塞性冠状动脉的临床标准:临床医生与患者共识声明

Clinical standards in angina and non-obstructive coronary arteries: A clinician and patient consensus statement.

作者信息

Berry Colin, Camici Paolo G, Crea Filippo, George Maria, Kaski Juan Carlos, Ong Peter, Pepine Carl J, Pompa Annette, Sechtem Udo, Shimokawa Hiroaki, Zeitz Christopher, Escaned Javier, van de Hoef Tim P, Beltrame John F, Merz C Noel Bairey

机构信息

British Heart Foundation Glasgow Cardiovascular Research Centre, School of Cardiovascular and Metabolic Health, University of Glasgow, UK; West of Scotland Heart and Lung Centre, NHS Golden Jubilee hospital, Clydebank, UK.

IRCCS San Raffaele Hospital, Milan. Italy.

出版信息

Int J Cardiol. 2025 Jun 15;429:133162. doi: 10.1016/j.ijcard.2025.133162. Epub 2025 Mar 13.

Abstract

Patients with angina and non-obstructive coronary arteries (ANOCA) or myocardial ischaemia with non-obstructive coronary arteries (INOCA) comprise a relatively large subgroup within those with ischaemic heart disease. Advances in the understanding of disease mechanisms, diagnostic tests and multidisciplinary care are improving awareness of the needs of affected individuals. However, practice variations and suboptimal management promulgate the health burden and increase health care resource consumption. Clinical standards represent a limited number of quality statements that describe the care patients should be offered by health professionals and providers for a specific clinical condition or defined clinical pathway in line with current best evidence. Clinical standards should address implementation of this evidence along with education of patients and healthcare professionals, multidisciplinary care networks, and research. In this consensus statement, we highlight contemporary evidence and stakeholder views, including clinicians and patients, to provide an international perspective for developing clinical standards for services involving ANOCA/INOCA patients. A clinical service for ANOCA/INOCA should "consider the whole patient" and provide a multidisciplinary, patient-centred service.

摘要

患有心绞痛和非阻塞性冠状动脉疾病(ANOCA)或心肌缺血伴非阻塞性冠状动脉疾病(INOCA)的患者在缺血性心脏病患者中占比较大。在疾病机制理解、诊断测试和多学科护理方面的进展正在提高对受影响个体需求的认识。然而,实践差异和管理欠佳加剧了健康负担并增加了医疗资源消耗。临床标准是数量有限的质量声明,描述了卫生专业人员和提供者应根据当前最佳证据为特定临床状况或明确的临床路径下的患者提供的护理。临床标准应涉及该证据的实施以及患者和医疗专业人员的教育、多学科护理网络和研究。在本共识声明中,我们强调当代证据和包括临床医生及患者在内的利益相关者的观点,以提供制定涉及ANOCA/INOCA患者服务临床标准的国际视角。针对ANOCA/INOCA的临床服务应“考虑患者整体”并提供多学科、以患者为中心的服务。

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