INOCA: coronary microvascular disease responsible for perfusion abnormality?

The question was posed of whether myocardial perfusion imaging can predict the outcomes of patients with angina and ischemia with no obstructive coronary artery disease (INOCA). It was found that in INOCA patients, perfusion abnormalities were seen, which may be due to coronary microvascular disease. This allowed to identify patients who faced a higher risk of morbidity. This highlights the value of myocardial perfusion imaging, as it is commonly used for patients with obstructive coronary artery disease, but very rarely for those with the non-obstructive kind. As such, this underscores the need to assess risk-stratification in patients with INOCA more thoroughly to improve disease management and outcomes.

This review by Sharir T & Brodkin B aimed to assess the use of myocardial perfusion imaging in patients with ischemia with no obstructive coronary artery disease, INOCA

Key learnings:

Further research is required into understanding the optimal methods for risk-stratification and disease management for patients with ischemia with no obstructive coronary artery disease (INOCA). Using methods such as myocardial perfusion imaging, which is commonly used for obstructive diseases, may bring beneficial results in the outcomes of INOCA patients.