INOCA – Ischemia and No Obstructive Coronary Artery Disease
INOCA – Ischemia and No Obstructive Coronary Artery Disease
Description: https://johnsonfrancis.org/profession… Discussion on INOCA – ischemia and no obstructive coronary artery disease. INOCA is the acronym for Ischemia and No Obstructive Coronary Artery Disease. They have elevated risk for cardiovascular events like acute coronary syndrome and hospitalization for heart failure. Risk of development of heart failure with preserved ejection fraction is also higher in these subjects. Some of them have coronary microvascular dysfunction and evidence of inflammation. In spite of the absence of obstructive coronary arteries, they have a risk of repeated hospitalizations and repeated coronary angiographies, involving significant health care costs. In general, INOCA is more common in females. They tend to have coronary microvascular dysfunction, plaque erosion and thrombus formation. They may have more extensive non obstructive coronary artery disease and have associated hypertension and diabetes mellitus. Major adverse events are similar to those with obstructive coronary artery disease. The CORE320 Study was an observational study of INOCA defined with CT angiography and CT perfusion imaging. Invasive coronary angiography and single photon emission computed tomography (SPECT) were also performed. 381 symptomatic persons referred for invasive coronary angiography underwent CT angiography, rest-adenosine stress CT perfusion and rest-stress SPECT prior to invasive coronary angiography. They were divided into three groups depending on CT angiography/CT perfusion or invasive coronary angiography/SPECT data. Group A had 50% or more coronary stenosis. Group B had no obstructive stenosis, but ischemia (INOCA). Group C had no obstructive stenosis and normal perfusion imaging results. 31 of the 115 participants without obstructive coronary artery disease at CT angiography had abnormal CT perfusion studies. In those who had a combination of invasive coronary angiography and SPECT, 45 of the 151 without obstructive coronary artery disease had INOCA. Those with INOCA had greater atherosclerotic burden and more adverse plaque features on CT compared with those who had no obstructive stenosis and no ischemia. This would imply that treatment aimed at prevention of progression of atherosclerosis is needed in those with INOCA. An accompanying editorial mentioned that CT perfusion provides data on the presence of microvascular dysfunction in INOCA.
Content
0.199 -> Discussion on INOCA – ischemia and no obstructive
coronary artery disease.
6.54 -> INOCA is the acronym for Ischemia and No Obstructive
Coronary Artery Disease.
12.089 -> They have elevated risk for cardiovascular
events like acute coronary syndrome and hospitalization
18.8 -> for heart failure.
20.63 -> Risk of development of heart failure with
preserved ejection fraction is also higher
25.29 -> in these subjects.
26.87 -> Some of them have coronary microvascular dysfunction
and evidence of inflammation.
33.71 -> In spite of the absence of obstructive coronary
arteries, they have a risk of repeated hospitalizations
40.92 -> and repeated coronary angiographies, involving
significant health care costs.
46.06 -> In general, INOCA is more common in females.
49.77 -> They tend to have coronary microvascular dysfunction,
plaque erosion and thrombus formation.
56.94 -> They may have more extensive non obstructive
coronary artery disease and have associated
62.329 -> hypertension and diabetes mellitus.
65.19 -> Major adverse events are similar to those
with obstructive coronary artery disease.
70.219 -> The CORE320 Study was an observational study
of INOCA defined with CT angiography and CT
77.079 -> perfusion imaging.
79.56 -> Invasive coronary angiography and single photon
emission computed tomography (SPECT) were
84.52 -> also performed.
86.42 -> 381 symptomatic persons referred for invasive
coronary angiography underwent CT angiography,
94.529 -> rest-adenosine stress CT perfusion and rest-stress
SPECT prior to invasive coronary angiography.
102.319 -> They were divided into three groups depending
on CT angiography/CT perfusion or invasive
108.68 -> coronary angiography/SPECT data.
111.88 -> Group A had 50% or more coronary stenosis.
116.06 -> Group B had no obstructive stenosis, but ischemia
(INOCA).
121.829 -> Group C had no obstructive stenosis and normal
perfusion imaging results.
126.539 -> 31 of the 115 participants without obstructive
coronary artery disease at CT angiography
133.53 -> had abnormal CT perfusion studies.
136.579 -> In those who had a combination of invasive
coronary angiography and SPECT, 45 of the
142.379 -> 151 without obstructive coronary artery disease
had INOCA.
147.94 -> Those with INOCA had greater atherosclerotic
burden and more adverse plaque features on
154.09 -> CT compared with those who had no obstructive
stenosis and no ischemia.
160.319 -> This would imply that treatment aimed at prevention
of progression of atherosclerosis is needed
166.73 -> in those with INOCA.
168.68 -> An accompanying editorial mentioned that CT
perfusion provides data on the presence of
