INOCA and quality of life: a review
Traditionally, clinicians have focused on obstructive coronary artery disease (CAD), yet over 2 in 5 patients with angina do not experience obstruction. Ischemia with non-obstructive coronary arteries, also known as INOCA, is now being increasingly recognised, yet there is a lack of guidelines and awareness surrounding the patients’ quality of life. INOCA was demonstrated to have adverse effects on quality of life, whether physical, mental or social. This was found through a self-reported survey of 1579 members of the INOCA International patient support group. Patients stated effects such as psychological stress, anxiety, depression (affecting mental and social health), the inability to continue normal working hours at their jobs (leading to reduction in hours, or leaving the workplace entirely), application for disability, and many more.
This review by Gulati M et al. aimed to determine the links between INOCA and self-perceived quality of life, to highlight the missing guidelines surrounding its diagnosis and management.
With around 80% of participants claiming INOCA lead to adverse effects on their home and social life, and 70% claiming a mental health decline, focusing solely on diagnosis of INOCA does not provide adequate support for patients. There needs to be recognition, awareness and guidelines to aid patients in coping with these symptoms.