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Prevalence of Coronary Microvascular Disease and Coronary Vasospasm in Patients With Nonobstructive Coronary Artery Disease: Systematic Review and Meta-Analysis

Journal of the American Heart Association, 2022-04, Vol.11 (7), p.e023207-e023207 [Peer Reviewed Journal]

2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. ;ISSN: 2047-9980 ;EISSN: 2047-9980 ;DOI: 10.1161/JAHA.121.023207 ;PMID: 35301851

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Title:
Prevalence of Coronary Microvascular Disease and Coronary Vasospasm in Patients With Nonobstructive Coronary Artery Disease: Systematic Review and Meta-Analysis
Author: Mileva, Niya ; Nagumo, Sakura ; Mizukami, Takuya ; Sonck, Jeroen ; Berry, Colin ; Gallinoro, Emanuele ; Monizzi, Giovanni ; Candreva, Alessandro ; Munhoz, Daniel ; Vassilev, Dobrin ; Penicka, Martin ; Barbato, Emanuele ; De Bruyne, Bernard ; Collet, Carlos
Subjects: angina with nonobstructive coronary artery disease ; Coronary Angiography ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - epidemiology ; Coronary Vasospasm - diagnostic imaging ; Coronary Vasospasm - epidemiology ; Coronary Vessels - diagnostic imaging ; Female ; Humans ; ischemia with no obstructive coronary artery disease ; Male ; Microcirculation ; Microvascular Angina ; Prevalence ; Systematic Review and Meta‐analysis ; vasospastic angina
Is Part Of: Journal of the American Heart Association, 2022-04, Vol.11 (7), p.e023207-e023207
Description: Background A relevant proportion of patients with suspected coronary artery disease undergo invasive coronary angiography showing normal or nonobstructive coronary arteries. However, the prevalence of coronary microvascular disease (CMD) and coronary spasm in patients with nonobstructive coronary artery disease remains to be determined. The objective of this study was to determine the prevalence of coronary CMD and coronary vasospastic angina in patients with no obstructive coronary artery disease. Methods and Results A systematic review and meta-analysis of studies assessing the prevalence of CMD and vasospastic angina in patients with no obstructive coronary artery disease was performed. Random-effects models were used to determine the prevalence of these 2 disease entities. Fifty-six studies comprising 14 427 patients were included. The pooled prevalence of CMD was 0.41 (95% CI, 0.36-0.47), epicardial vasospasm 0.40 (95% CI, 0.34-0.46) and microvascular spasm 24% (95% CI, 0.21-0.28). The prevalence of combined CMD and vasospastic angina was 0.23 (95% CI, 0.17-0.31). Female patients had a higher risk of presenting with CMD compared with male patients (risk ratio, 1.45 [95% CI, 1.11-1.90]). CMD prevalence was similar when assessed using noninvasive or invasive diagnostic methods. Conclusions In patients with no obstructive coronary artery disease, approximately half of the cases were reported to have CMD and/or coronary spasm. CMD was more prevalent among female patients. Greater awareness among physicians of ischemia with no obstructive coronary arteries is urgently needed for accurate diagnosis and patient-tailored management.
Publisher: England: John Wiley and Sons Inc
Language: English
Identifier: ISSN: 2047-9980
EISSN: 2047-9980
DOI: 10.1161/JAHA.121.023207
PMID: 35301851
Source: Open Access: Wiley Blackwell Open Access Journals
Geneva Foundation Free Medical Journals at publisher websites
MEDLINE
PubMed Central（OA）
ROAD: Directory of Open Access Scholarly Resources
DOAJ Directory of Open Access Journals

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Prevalence of Coronary Microvascular Disease and Coronary Vasospasm in Patients With Nonobstructive Coronary Artery Disease: Systematic Review and Meta-Analysis

2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. ;ISSN: 2047-9980 ;EISSN: 2047-9980 ;DOI: 10.1161/JAHA.121.023207 ;PMID: 35301851

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