What an interventionalist needs to know about INOCA

Ang, D. T. Y. and Berry, C. (2021) What an interventionalist needs to know about INOCA. Interventional Cardiology Review, 16, e32. (doi: 10.15420/icr.2021.16) (PMID:34950239) (PMCID:PMC8674629)

Abstract

Ischaemia with non-obstructed coronary artery disease (INOCA) remains a diagnostic and therapeutic challenge. An anatomical investigation-based approach to ischaemic heart disease fails to account for disorders of vasomotion. The main INOCA endotypes are microvascular angina, vasospastic angina, mixed (both) or non-cardiac symptoms. The interventional diagnostic procedure (IDP) enables differentiation between clinical endotypes, with linked stratified medical therapy leading to a reduced symptom burden and a better quality of life. Interventionists are therefore well placed to make a positive impact with more personalised care. Despite adjunctive tests of coronary function being supported by contemporary guidelines, IDP use in daily practice remains limited. More widespread adoption should be encouraged. This article reviews a stratified approach to INOCA, describes a streamlined approach to the IDP and highlights some practical and safety considerations.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ang, Dr Daniel and Berry, Professor Colin
• Authors: Ang, D. T. Y., and Berry, C.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Interventional Cardiology Review
• Publisher: Radcliffe Cardiology
• ISSN: 1756-1485
• ISSN (Online): 1756-1485
• Published Online: 08 December 2021
• Copyright Holders: Copyright © 2021 Radcliffe Cardiology
• First Published: First published in Interventional Cardiology Review 16: e32
• Publisher Policy: Reproduced under a Creative Commons License