Open AccessAn EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries in Collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders International Study Group
Author(s) -
Vijay Kunadian,
Alaide Chieffo,
Paolo G. Camici,
Colin Berry,
Javier Escaned,
Angela H.E.M. Maas,
Eva Prescott,
Nicole Karam,
Yolande Appelman,
Chiara Fraccaro,
Gill Louise Buchanan,
Stéphane Manzo-Silberman,
Rasha AlLamee,
Evelyn Regar,
Alexandra J. Lansky,
J. Dawn Abbott,
Lina Badimón,
Dirk J. Duncker,
Roxana Mehran,
Davide Capodanno,
Andreas Baumbach
Publication year - 2021
Publication title -
eurointervention
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.592
H-Index - 78
eISSN - 1969-6213
pISSN - 1774-024X
DOI - 10.4244/eijy20m07_01
Subject(s) - medicine , angina , cardiology , coronary vasospasm , coronary arteries , coronary artery disease , asymptomatic , canadian cardiovascular society , psychological intervention , intensive care medicine , artery , myocardial infarction , psychiatry
This consensus document, a summary of the views of an expert panel organized by the European Association of Percutaneous Cardiovascular Interventions (EAPCI), appraises the importance of ischaemia with non-obstructive coronary arteries (INOCA). Angina pectoris affects approximately 112 million people globally. Up to 70% of patients undergoing invasive angiography do not have obstructive coronary artery disease, more common in women than in men, and a large proportion have INOCA as a cause of their symptoms. INOCA patients present with a wide spectrum of symptoms and signs that are often misdiagnosed as non-cardiac leading to under-diagnosis/investigation and under-treatment. INOCA can result from heterogeneous mechanism including coronary vasospasm and microvascular dysfunction and is not a benign condition. Compared to asymptomatic individuals, INOCA is associated with increased incidence of cardiovascular events, repeated hospital admissions, as well as impaired quality of life and associated increased health care costs. This consensus document provides a denition of INOCA and guidance to the community on the diagnostic approach and management of INOCA based on existing evidence from research and best available clinical practice; noting gaps in knowledge and potential areas for further investigation.