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Non-obstructive Plaque and Treatment of INOCA: More to Be Learned

  • Women and Ischemic Heart Disease (J.M. Peña and F. Lin, Section Editors)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

A significant proportion of patients evaluated for chest pain have ischemia with non-obstructive coronary artery disease (INOCA). Studies have shown INOCA is associated with increased risk of major adverse cardiac events and significant burden on the health care system.

Recent Findings

While there is scarce scientific evidence on management of INOCA, the CorMicA trial showed that stratified medical therapy based on the type of INOCA improved patients’ symptoms and quality of life. There are multiple ongoing trials, including Women’s IschemiA Trial to Reduce Events in Non-ObstRuctIve CORonary Artery Disease (WARRIOR trial), assessing the benefit of intensive medical therapy versus usual care for this increasingly recognized clinical entity.

Summary

In this review, we discuss the definition of INOCA, epidemiology and risk factors, pathophysiology, and management as well as the current knowledge gaps and ongoing clinical trials in this arena.

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Funding

Dr. Pepine receives funding related to the topic from the National Institutes of Health (R01HL146158, WISE HFpEF https://clinicaltrials.gov/ct2/show/NCT02582021) and the US Department of Defense (W81XWH-17–2-0030, WARRIOR https://clinicaltrials.gov/ct2/show/NCT03417388).

Author information

Authors and Affiliations

  1. Division of Interventional Cardiology, Henry Ford Hospital, Detroit, MI, USA

    Lina Ya’Qoub

  2. Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar

    Islam Y. Elgendy

  3. Division of Cardiovascular Medicine, University of Florida, 1329 SW 16th St, PO Box 100288, Gainesville, FL, USA

    Carl J. Pepine

Authors
  1. Lina Ya’Qoub
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  2. Islam Y. Elgendy
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Correspondence to Carl J. Pepine.

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Ya’Qoub, L., Elgendy, I.Y. & Pepine, C.J. Non-obstructive Plaque and Treatment of INOCA: More to Be Learned. Curr Atheroscler Rep 24, 681–687 (2022). https://doi.org/10.1007/s11883-022-01044-4

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