Ischemia with no obstructive coronary artery disease (INOCA): A patient self-report quality of life survey from INOCA international

Gulati, Martha; Khan, Najah; George, Maria; Berry, Colin; Chieffo, Alaide; Camici, Paolo G.; Crea, Filippo; Kaski, Juan‐Carlos; Marzilli, Mario; Merz, C. Noel Bairey

doi:10.1016/j.ijcard.2022.09.047

Cited by 38 publications

(15 citation statements)

References 29 publications

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“…Patients with nonobstructive CAD, so-called “normal” or negative coronary angiograms, are often dismissed as having noncardiac chest pain, thereby missing the opportunities for recommended treatment. 6 The W omen’s I schemia S yndrome E valuation WISE study 92 demonstrated a significant 31% CVD mortality in women with INOCA in 10-year follow-up. Similarly, the V ariation i n R ecovery: Role of G ender on O utcomes of Young AMI Patients (VIRGO) study 20 demonstrated that 1-year mortality rates were similar for obstructive ACS and nonobstructive ACS.…”

Section: Methodsmentioning

confidence: 99%

“… 5 CVD morbidity also is disproportionately greater in women than in men, as women are 20% more likely than men to die within the year following an acute myocardial infarction (MI) and to experience heart failure or stroke within 5 years after acute MI. 3 , 6 , 7 , 8 The observation has been made that CVD risk factors, including smoking, hypertension, diabetes, obesity, physical inactivity, depression, and anxiety, are disproportionately more harmful in women than they are in men, 9 and that sex- and gender-specific differences exist in awareness, symptom presentation, diagnosis, prognosis, and treatment of CVD, with women receiving fewer referrals to indicated procedures and therapies. 10 …”

mentioning

confidence: 99%

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The Development of a Chest Pain Protocol for Women Presenting to the Emergency Department

Jaffer,

Noble,

Pozgay

et al. 2023

CJC Open

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

The Development of a Chest Pain Protocol for Women Presenting to the Emergency Department

Jaffer,

Noble,

Pozgay

et al. 2023

CJC Open

Self Cite

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“…INOCA is not a benign condition and has a relevant influence on patients’ lives, affecting their home and social lives with >70% reporting an impact on mental health. 5 Furthermore, an increased risk for major adverse outcomes in this population is reported, predominantly represented by hospitalization for recurrent angina, heart failure or both. 6 Clinical research in these scenarios has recently garnered significant interest, leading to improved definition, prognostic stratification and pathophysiological classification to prevent misdiagnosis and under treatment.…”

Section: Introductionmentioning

confidence: 95%

Vasospastic angina: a review on diagnostic approach and management

Jenkins,

Pompei,

Ganzorig

et al. 2024

Therapeutic Advances in Cardiovascular Disease

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Vasospastic angina (VSA) refers to chest pain experienced as a consequence of myocardial ischaemia caused by epicardial coronary spasm, a sudden narrowing of the vessels responsible for an inadequate supply of blood and oxygen. Coronary artery spasm is a heterogeneous phenomenon that can occur in patients with non-obstructive coronary arteries and obstructive coronary artery disease, with transient spasm causing chest pain and persistent spasm potentially leading to acute myocardial infarction (MI). VSA was originally described as Prinzmetal angina or variant angina, classically presenting at rest, unlike most cases of angina (though in some patients, vasospasm may be triggered by exertion, emotional, mental or physical stress), and associated with transient electrocardiographic changes (transient ST-segment elevation, depression and/or T-wave changes). Ischaemia with non-obstructive coronary arteries (INOCA) is not a benign condition, as patients are at elevated risk of cardiovascular events including acute coronary syndrome, hospitalization due to heart failure, stroke and repeat cardiovascular procedures. INOCA patients also experience impaired quality of life and associated increased healthcare costs. VSA, an endotype of INOCA, is associated with major adverse events, including sudden cardiac death, acute MI and syncope, necessitating the study of the most effective treatment options currently available. The present literature review aims to summarize current data relating to the diagnosis and management of VSA and provide details on the sequence that treatment should follow.

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“…15 The purpose of intracoronary imaging should not be limited to guiding the revascularization strategy but also to minimize stent implantation in ACS patients. 16 Both CMD and vasospastic angina (VSA) are reported more frequently in women 17 and could be responsible for transient mismatch between blood supply and myocardial oxygen demands. Particularly, coronary artery spasm is a heterogeneous phenomenon that can also coexist with obstructive CAD with transient spasm provoking chest pain and persistent spasm leading to ACS.…”

Section: Imaging and Coronary Function Testingmentioning

confidence: 99%

Reading 2023 ESC ACS guidelines between the lines: Gaps in evidence in women

Pompei,

van de Hoef,

den Ruijter

et al. 2023

Eur J Clin Investigation

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The terms sex and gender are often used interchangeably, yet 'sex' refers to biological and physiologic traits characterizing maleness and femaleness. 'Gender' refers to the roles and behaviours of men, women and the different gender diversities in between the two. Biological sex and sociocultural gender are often intimately connected and significant factors that impact cardiovascular health. In this editorial, we highlight the knowledge gaps on women in the 2023 ACS guidelines and mostly refer to sex differences, as we hypothesize that sex is one of the main drivers behind the pathophysiological differences in ACS between women and men.Cardiovascular disease (CVD) remains the leading cause of death worldwide among women accounting for 8.9 million deaths in 2019. 1,2 The European Society of Cardiology (ESC) recently published the 2023 guidelines on the management of acute coronary syndromes (ACS). For the first time, the task force members grouped unstable angina (UA), non-ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarction (STEMI) under a single spectrum of ACS taking into account clinical presentation, ECG and diagnostic work-up. 3 Guideline recommendations are based on evidence generated from randomized controlled trials (RCTs) and metaanalyses. Given women represent approximately 20%-30% of patients in RCTs of acute coronary syndromes, the recommendations are based on evidence from studies with majority representation of male patients.

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Ischemia with no obstructive coronary artery disease (INOCA): A patient self-report quality of life survey from INOCA international

Cited by 38 publications

References 29 publications

The Development of a Chest Pain Protocol for Women Presenting to the Emergency Department

The Development of a Chest Pain Protocol for Women Presenting to the Emergency Department

Vasospastic angina: a review on diagnostic approach and management

Reading 2023 ESC ACS guidelines between the lines: Gaps in evidence in women

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