Ischemia and no obstructive coronary arteries (INOCA): A narrative review

Mehta, Puja K.; Huang, Jingwen; Levit, Rebecca; Malas, Waddah; Waheed, Nida; Merz, C. Noel Bairey

doi:10.1016/j.atherosclerosis.2022.11.009

Cited by 44 publications

(10 citation statements)

References 189 publications

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“…A Welch Allyn 4200B apparatus (Aston Abbotts, UK) was used for the measurements. Measurements were made three times according to the guidelines of experts of the European Society of Hypertension [ 14 ]. The average of three measurements was calculated for each participant.…”

Section: Methodsmentioning

confidence: 99%

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Prevalence of dyslipidaemia within Polish nurses. Cross-sectional study - single and multiple linear regression models and ROC analysis

Bartosiewicz,

Wyszyńska,

Matłosz

et al. 2024

BMC Public Health

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Background Maintaining good health is vital not only for own well-being, but also to ensure high-quality patient care. The aim of this study was to evaluate the prevalence of dyslipidaemia and to determine the factors responsible for the development of this disorder among Polish nurses. Lipid profile disorders are the most prevalent and challenging risk factors for the development of cardiovascular disease. Nurses have significant potential and play a crucial role in providing care and treatment services. Methods This cross-sectional study involved nurses and included measurements of body weight composition (Tanita MC-980), body mass index, waist circumference, blood pressure (Welch Allyn 4200B), lipid profile, and fasting blood glucose (CardioChek PA). Results The results revealed that more than half of the nurses (60.09%) were overweight or obese, with 57.28% exhibiting elevated blood pressure, 32.25% having fasting glucose levels, and 69.14% experiencing dyslipidaemia. Multiple model evaluation using ROC curves demonstrated that multiple models accurately predicted hypercholesterolemia (AUC = 0.715), elevated LDL (AUC = 0.727), and elevated TC (AUC = 0.723) among Polish nurses. Conclusion Comprehensive education programmes should be implemented that include the latest advances in cardiovascular disease prevention. Regular check-ups, as well as the promotion and availability of healthy food in hospital canteens, are essential.

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Section: Methodsmentioning

confidence: 99%

“…Although INOCA affects both women and men, women are more likely to be diagnosed with INOCA and experience more severe effects of angina, leading to recurrent hospitalisations and reduced quality of life. This is particularly relevant for nurses, as most of them are women [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of dyslipidaemia within Polish nurses. Cross-sectional study - single and multiple linear regression models and ROC analysis

Bartosiewicz,

Wyszyńska,

Matłosz

et al. 2024

BMC Public Health

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“…SIHD classically presents as stable angina, although it can also manifest as chest pressure, jaw discomfort, arm discomfort, dyspnea, and epigastric discomfort [ 17 ]. There is also increasing recognition that processes such as epicardial coronary or microvascular dysfunction can also play a role in the development of myocardial ischemia, with or without concurrent obstructive atherosclerotic disease [ 18 ]. More rarely, ischemic damage can result from alternative pathologies, such as coronary dissection, arteritis, myocardial bridging, thromboembolism, or vasospasm [ 19 ].…”

Section: Distinguishing Between Myocardial Injury Myocardial Ischemia...mentioning

confidence: 99%

Clinical Interpretation of Serum Troponin in the Era of High-Sensitivity Testing

Maayah,

Grubman,

Allen

et al. 2024

Diagnostics

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Cardiac troponin (Tn) plays a central role in the evaluation of patients with angina presenting with acute coronary syndrome. The advent of high-sensitivity assays has improved the analytic sensitivity and precision of serum Tn measurement, but this advancement has come at the cost of poorer specificity. The role of clinical judgment is of heightened importance because, more so than ever, the interpretation of serum Tn elevation hinges on the careful integration of findings from electrocardiographic, echocardiographic, physical exam, interview, and other imaging and laboratory data to formulate a weighted differential diagnosis. A thorough understanding of the epidemiology, mechanisms, and prognostic implications of Tn elevations in each cardiac and non-cardiac etiology allows the clinician to better distinguish between presentations of myocardial ischemia and myocardial injury—an important discernment to make, as the treatment of acute coronary syndrome is vastly different from the workup and management of myocardial injury and should be directed at the underlying cause.

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“…Moreover, the absence of clear guidelines regarding the optimal timing and patient selection for CMD evaluation further complicates the diagnostic dilemma. However, CMD assessment is important, as a CMD diagnosis and treatment can lead to reduced cardiovascular events, decrease angina, prevent hospital readmissions for angina and repeat angiography, and enable tailored medical interventions and improved patient outcomes 10–13 …”

Section: Introductionmentioning

confidence: 99%

“…However, CMD assessment is important, as a CMD diagnosis and treatment can lead to reduced cardiovascular events, decrease angina, prevent hospital readmissions for angina and repeat angiography, and enable tailored medical interventions and improved patient outcomes. [10][11][12][13] This comprehensive study aims to evaluate the procedural aspects of invasive CMD assessment as compared to diagnostic left heart catheterization (DLHC) in patients found to not have an obstructive CAD but who did not undergo CMD assessment.…”

mentioning

confidence: 99%

Coronary microvascular dysfunction assessment: A comparative analysis of procedural aspects

Merdler,

Wallace,

Banerjee

et al. 2024

Cathet Cardio Intervent

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BackgroundFull adoption of coronary microvascular dysfunction (CMD) assessment faces challenges due to its invasive nature and concerns about prolonged procedure time and increased contrast and/or radiation exposure. We compared procedural aspects of CMD invasive assessment to diagnostic left heart catheterization (DLHC) in patients with chest pain who were not found to have obstructive coronary artery disease.MethodsA total of 227 patients in the Coronary Microvascular Disease Registry were compared to 1592 patients who underwent DLHC from August 2021 to November 2023. The two cohorts were compared using propensity‐score matching; primary outcomes were fluoroscopy time and total contrast use.ResultsThe participants' mean age was 64.1 ± 12.6 years. CMD‐assessed patients were more likely to be female (66.5% vs. 45.2%, p < 0.001) and have hypertension (80.2% vs. 44.5%, p < 0.001), history of stroke (11.9% vs. 6.3%, p = 0.002), and history of myocardial infarction (20.3% vs. 7.7%, p < 0.001). CMD assessment was safe, without any reported adverse outcomes. A propensity‐matched analysis showed that patients who underwent CMD assessment had slightly higher median contrast exposure (50 vs. 40 mL, p < 0.001), and slightly longer fluoroscopy time (6.9 vs. 4.7 min, p < 0.001). However, there was no difference in radiation dose (209.3 vs. 219 mGy, p = 0.58) and overall procedure time (31 vs. 29 min, p = 0.37).ConclusionCompared to DLHC, CMD assessment is safe and requires only slightly additional contrast use (10 mL) and slightly longer fluoroscopy time (2 min) without clinical implications. These findings emphasize the favorable safety and feasibility of invasive CMD assessment.

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Ischemia and no obstructive coronary arteries (INOCA): A narrative review

Cited by 44 publications

References 189 publications

Prevalence of dyslipidaemia within Polish nurses. Cross-sectional study - single and multiple linear regression models and ROC analysis

Prevalence of dyslipidaemia within Polish nurses. Cross-sectional study - single and multiple linear regression models and ROC analysis

Clinical Interpretation of Serum Troponin in the Era of High-Sensitivity Testing

Coronary microvascular dysfunction assessment: A comparative analysis of procedural aspects

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