Ford, T. and Berry, C. (2019) How to diagnose and manage angina without obstructive coronary artery disease: Lessons from the British Heart Foundation CorMicA trial. Interventional Cardiology Review, 14(2), pp. 76-82. (doi: 10.15420/icr.2019.04.R1) (PMID:31178933) (PMCID:PMC6545998)
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Abstract
Patients with symptoms and/or signs of ischaemia but no obstructive coronary artery disease (INOCA) present a diagnostic and therapeutic challenge. Microvascular and/or vasospastic angina are the two most common causes of INOCA; however, invasive coronary angiography lacks the sensitivity to diagnose these functional coronary disorders. In this article, the authors summarise the rationale for invasive testing in the absence of obstructive coronary disease, namely that correct treatment for angina patients starts with the correct diagnosis. They provide insights from the CORonary MICrovascular Angina (CorMicA) study, where an interventional diagnostic procedure was performed with linked medical therapy to improve patient health. Identification of these distinct disorders (microvascular angina, vasospastic angina or non-cardiac chest pain) is key for stratifying INOCA patients, allowing prognostic insights and better patient care with linked therapy based on contemporary guidelines. Finally, they propose a framework to diagnose and manage patients in this common clinical scenario.
| Item Type: | Articles |
|---|---|
| Additional Information: | CorMicA study is an investigator-initiated clinical trial that was funded by the British Heart Foundation (PG/17/2532884; RE/13/5/30177; RE/18/634217). Clinicaltrials.gov: NCT03193294. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Ford, Thomas and Berry, Professor Colin |
| Authors: | Ford, T., and Berry, C. |
| College/School: | College of Medical Veterinary and Life Sciences College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | Interventional Cardiology Review |
| Publisher: | Radcliffe Cardiology |
| ISSN: | 1756-1477 |
| ISSN (Online): | 1756-1485 |
| Copyright Holders: | Copyright © 2019 Radcliffe Cardiology |
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