INOCA prevalence, diagnosis and management
Ischemia with non-obstructive coronary arteries, INOCA, shows a strong female predominance within the estimated 3-4 million individuals who suffer from it. INOCA can be diagnosed through invasive or non-invasive techniques, assessing coronary flow reserve and the Index of Microcirculatory Resistance. Despite this, women with INOCA receive lower rates of medical care due to dismissal by clinicians, with overall less than half of INOCA patients being treated with appropriate anti-ischemic agents. This poses risks as INOCA is associated with recurrent hospitalisation, marked decreases in quality of life and adverse cardiovascular outcomes.
This review by Hansen B et al. aimed to evaluate the prevalence and diagnosis, as well as highlight the gaps in the current management, of INOCA.
INOCA needs to be understood in all its heterogeneity of disease mechanism to allow for optimal diagnosis and management, with a focus required on ensuring gender equality is maintained with the screening and diagnosis processes. Optimal treatments of INOCA are currently being investigated in ongoing clinical trials, with the potential to lead to positive outcomes for both improving cardiovascular outcomes and increasing patient quality of life.