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[无阻塞性冠状动脉疾病患者的诊断与治疗。西班牙心脏病学会-临床心脏病学协会/西班牙心脏病学会-介入心脏病学协会/西班牙心脏病学会-缺血性心脏病与急性心脏护理协会/西班牙心脏病学会-心血管影像协会共识文件]

[Diagnosis and treatment of patients with ANOCA. Consensus document of the SEC-Clinical Cardiology Association/SEC-Interventional Cardiology Association/SEC-Ischemic Heart Disease and Acute Cardiac Care Association/ SEC-Cardiovascular Imaging Association].

作者信息

Escobar Carlos, Gómez Lara Josep, Escaned Javier, Carol Ruiz Antoni, Gutiérrez Ibañes Enrique, Fernández Friera Leticia, Raposeiras-Roubín Sergio, Alonso Martín Joaquín, Agüero Jaume, Gámez Jose María, Jorge-Pérez Pablo, Freixa-Pamias Román, Barrios Vivencio, Cruz González Ignacio, Martínez Monzonís Amparo, Viana Tejedor Ana

机构信息

Servicio de Cardiología, Hospital Universitario La Paz, Madrid, España Servicio de Cardiología Hospital Universitario La Paz Madrid España.

Servicio de Cardiología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España Servicio de Cardiología Hospital Universitari de Bellvitge L'Hospitalet de Llobregat España.

出版信息

REC Interv Cardiol. 2023 Dec 20;6(2):106-116. doi: 10.24875/RECIC.M23000422. eCollection 2024 Apr-Jun.

DOI:10.24875/RECIC.M23000422
PMID:40416348
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12097376/
Abstract

A substantial number of patients undergoing coronary angiography for angina or ischemia in noninvasive tests have coronary arteries without lesions or with nonsignificant stenosis. Many of these patients have nonobstructive myocardial ischemia (INOCA/ANOCA), which is an entity with prognostic importance that significantly affects patients' quality of life. The absence of a proper diagnosis leads to inappropriate medical treatment, repeat diagnostic tests, and greater use of social and health resources. An adequate diagnostic strategy is required for individualized treatment that improves symptoms and quality of life. In this document from the SEC-Clinical Cardiology Association, SEC-Interventional Cardiology Association, SEC-Ischemic Heart Disease and Acute Cardiac Care Association, and SEC-Cardiovascular Imaging Association of the Spanish Society of Cardiology, we provide simple and practical algorithms, with the aim of facilitating the early diagnosis and most appropriate treatment for patients with ANOCA.

摘要

大量因心绞痛或无创检查显示缺血而接受冠状动脉造影的患者，其冠状动脉无病变或有非显著性狭窄。这些患者中有许多患有非阻塞性心肌缺血（INOCA/ANOCA），这是一种具有预后重要性的疾病，会显著影响患者的生活质量。缺乏正确诊断会导致不恰当的药物治疗、重复诊断检查以及更多地使用社会和卫生资源。需要一种适当的诊断策略来进行个体化治疗，以改善症状和生活质量。在西班牙心脏病学会的SEC临床心脏病学协会、SEC介入心脏病学协会、SEC缺血性心脏病和急性心脏护理协会以及SEC心血管成像协会的这份文件中，我们提供了简单实用的算法，旨在促进ANOCA患者的早期诊断和最恰当治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e6d/12097376/eb2d9dc3cd19/2604-7306-recic-6-2-106-en-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e6d/12097376/13d1258608e1/2604-7306-recic-6-2-106-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e6d/12097376/c9132a420c36/2604-7306-recic-6-2-106-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e6d/12097376/05a21af8484f/2604-7306-recic-6-2-106-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e6d/12097376/bffdb00fe1ea/2604-7306-recic-6-2-106-en-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e6d/12097376/bb617ba404f0/2604-7306-recic-6-2-106-en-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e6d/12097376/eb2d9dc3cd19/2604-7306-recic-6-2-106-en-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e6d/12097376/13d1258608e1/2604-7306-recic-6-2-106-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e6d/12097376/c9132a420c36/2604-7306-recic-6-2-106-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e6d/12097376/05a21af8484f/2604-7306-recic-6-2-106-gf3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e6d/12097376/bffdb00fe1ea/2604-7306-recic-6-2-106-en-gf1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e6d/12097376/bb617ba404f0/2604-7306-recic-6-2-106-en-gf2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e6d/12097376/eb2d9dc3cd19/2604-7306-recic-6-2-106-en-gf3.jpg

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本文引用的文献

1
JCS/CVIT/JCC 2023 Guideline Focused Update on Diagnosis and Treatment of Vasospastic Angina (Coronary Spastic Angina) and Coronary Microvascular Dysfunction.《日本循环学会/心血管介入治疗学会/日本心脏病学会2023年血管痉挛性心绞痛（冠状动脉痉挛性心绞痛）和冠状动脉微血管功能障碍诊断与治疗指南重点更新》
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Microvascular Resistance Reserve to Assess Microvascular Dysfunction in ANOCA Patients.评估非心源性心源性昏迷患者微血管功能障碍的微血管阻力储备。
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Ischemia and no obstructive coronary arteries (INOCA): A narrative review.
缺血但非阻塞性冠状动脉疾病（INOCA）：一篇叙述性综述。
Atherosclerosis. 2022 Dec;363:8-21. doi: 10.1016/j.atherosclerosis.2022.11.009. Epub 2022 Nov 12.
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Coronary microvascular dysfunction is associated with impaired cognitive function: the Cerebral-Coronary Connection study (C3 study).冠状动脉微血管功能障碍与认知功能障碍有关：脑冠状动脉连接研究（C3 研究）。
Eur Heart J. 2023 Jan 7;44(2):113-125. doi: 10.1093/eurheartj/ehac521.
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Endothelial dysfunction in patients with angina and non-obstructed coronary arteries is associated with an increased risk of mayor cardiovascular events. Results of the Spanish ENDOCOR registry.心绞痛和冠状动脉无阻塞患者的内皮功能障碍与主要心血管事件风险增加相关。西班牙ENDOCOR注册研究结果。
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Temporal Trends of the Prevalence of Angina With No Obstructive Coronary Artery Disease (ANOCA).无阻塞性冠状动脉疾病的心绞痛（ANOCA）患病率的时间趋势
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Clinical Practice Variations in the Management of Ischemia With No Obstructive Coronary Artery Disease.无阻塞性冠状动脉疾病的缺血管理中的临床实践差异。
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