Open AccessIs the problem of intact coronary arteries still or is it close to solving?
Author(s) -
А. Н. Сумин
Publication year - 2021
Publication title -
rossijskij kardiologičeskij žurnal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.141
H-Index - 14
eISSN - 2618-7620
pISSN - 1560-4071
DOI - 10.15829/1560-4071-2021-4139
Subject(s) - medicine , coronary arteries , cardiology , angina , coronary artery disease , coronary angiography , revascularization , artery , pathophysiology , radiology , myocardial infarction
The dominant paradigm in the diagnosis of patients with stable coronary artery disease was the identification of patients with obstructive lesions of the coronary arteries, and then - ensuring the possibility of myocardial revascularization. The diagnostic algorithms used until recently led to the fact that in invasive coronary angiography obstructive changes in the coronary arteries were detected in less than half of the cases. In the 2019 European Guidelines for the Diagnosis of Chronic Coronary Syndrome, this algorithm was significantly revised, but the results of its implementation have not yet been published. Currently, several pathophysiological variants of angina pectoris have been proposed, which can be identified by an interventional diagnostic procedure for invasive coronary angiography. Recent studies have shown that up to 90% of patients without obstructive lesions of the epicardial coronary arteries have microvascular or vasospastic angina. This review focuses on these topical aspects of the problem of intact coronary arteries.