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Int J Angiol 2020; 29(04): 250-255
DOI: 10.1055/s-0040-1709500
Rapid Communication

Gender-Related Differences in Clinical Presentation and Angiographic Findings in Patients with Ischemia and No Obstructive Coronary Artery Disease (INOCA): A Single-Center Observational Registry

Mauro Gitto
1   International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London, United Kingdom
2   Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
,
Francesco Gentile
1   International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London, United Kingdom
3   Fondazione Toscana Gabriele Monasterio, Pisa, Italy
,
Alexandra N. Nowbar
1   International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London, United Kingdom
,
Alaide Chieffo
2   Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
,
Rasha Al-Lamee
1   International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, London, United Kingdom
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Abstract

Ischemia and no obstructive coronary arteries (INOCA) is a common clinical presentation, with a variety of causes that are often not fully investigated in routine clinical practice. The goal of our study was to characterize a real-world population of patients with INOCA, with a deeper focus on symptoms and stress test findings. The study population consisted of 435 patients who underwent diagnostic coronary angiography for anginal symptoms and/or evidence of myocardial ischemia at non-invasive imaging. In all patients angiography demonstrated nonobstructive coronary artery disease (CAD, less than 30% luminal diameter stenosis or fractional flow reserve > 0.8 and/or instantaneous wave-free ratio  > 0.89). Fifty-four percent of the patients were women. Atypical clinical presentation was more common in women (59.5 vs. 49.5%, p = 0.037). Women were more likely to have normal coronary arteries than men (41.8 vs. 16.2%, p < 0.001), and less likely than men to have hemodynamically non-significant CAD (32.1 vs. 55.1%, p < 0.001). No significant correlation between typicality of symptoms and evidence of ischemia was found in those patients (244/435, 56.1%) who had either dobutamine stress echocardiography or electrocardiogram stress test. INOCA is a common clinical condition, prevalent in women often presenting with atypical symptoms.

Keywords

Ischemic heart disease - chronic coronary syndrome - INOCA - nonobstructive coronary artery disease - stress tests - atypical symptoms - heart disease in women


Publikationsverlauf

Artikel online veröffentlicht:
14. Mai 2020

© 2020. International College of Angiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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