Shedding Light on Treatment Options for Coronary Vasomotor Disorders: A Systematic Review

Abstract

Purpose Coronary vasomotor dysfunction embraces two specific clinical entities: coronary (micro)vascular spasm and microvascular dysfunction. The clinical manifestations of these entities are respectively called vasospastic angina (VSA) and microvascular angina (MVA). Over the years, these diseases have become more and more prominent and several studies aimed to investigate the best diagnostic and therapeutic strategies. Patients with coronary vasomotor disorders are often undertreated due to the absence of evidence-based guidelines. The purpose of this overview is to illustrate the various therapeutic options available for the optimized management of these patients. Methods A Medline search of full-text articles published in English from 1980 to April 2022 was performed. The main analyzed aspects of vasomotor disorders were treatment options. We also performed research on “Clinicaltrial.gov” for ongoing trials. Conclusion Coronary (micro)vascular spasm and microvascular dysfunction are clinical entities characterized by high prevalence and clinical representation. Several therapeutic strategies, both innovative and established, are available to optimize treatment and improve the quality of life of these patients.

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“…A combination of medications should be administered [ 179 ]: CCBs are the drug of choice, and the association of ACE-inhibitors and statins is often indicated. In case of inadequate control of symptoms, the addition of nicorandil, ranolazine and trimetazidine could be an option [ 180 ]. Beta-blockers should be avoided because they may exacerbate CAS [ 181 ].…”

Exploring the mechanisms of Guizhifuling pills in the treatment of coronary spastic angina based on network pharmacology combined with molecular docking

“…[8] Calcium channel blockers (CCBs) are the primary treatment approach for CSA. [9] However, 10% to 20% of patients with CSA are refractory to or intolerant of CCBs. Furthermore, long-acting nitrates can be used in combination with CCBs when the latter are ineffective.…”