TY - JOUR
T1 - Prevalence of microvascular angina among patients with stable symptoms in the absence of obstructive coronary artery disease
T2 - A systematic review
AU - Aribas, Elif
AU - Roeters van Lennep, Jeanine E.
AU - Elias-Smale, Suzette E.
AU - Piek, Jan J.
AU - Roos, Maurits
AU - Ahmadizar, Fariba
AU - Arshi, Banafsheh
AU - Duncker, Dirk J.
AU - Appelman, Yolande
AU - Kavousi, Maryam
N1 - © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Our purpose was to perform a systematic review to assess the prevalence of microvascular angina (MVA) among patients with stable symptoms in the absence of obstructive coronary artery disease (CAD). We performed a systematic review of the literature to group the prevalence of MVA, based on diagnostic pathways and modalities. We defined MVA using three definitions: (i) suspected MVA using non-invasive ischaemia tests; proportion of patients with non-obstructive CAD among patients with symptoms and a positive non-invasive ischaemia test result, (ii) suspected MVA using specific modalities for MVA; proportion of patients with evidence of impaired microvascular function among patients with symptoms and non-obstructive CAD, and (iii) definitive MVA; proportion of patients with positive ischaemia test results among patients with an objectified impaired microvascular dysfunction. We further examined the ratio of women-To-men for the different groups. Of the 4547 abstracts, 20 studies reported data on MVA prevalence. The median prevalence was 43% for suspected MVA using non-invasive ischaemia test, 28% for suspected MVA using specific modalities for MVA, and 30% for definitive MVA. Overall, more women were included in the studies reporting sex-specific data. The women-To-men ratio for included participants was 1.29. However, the average women-To-men ratio for the MVA cases was 2.50. In patients with stable symptoms of ischaemia in the absence of CAD, the prevalences of suspected and definitive MVA are substantial. The results of this study should warrant cardiologists to support, promote and facilitate the comprehensive evaluation of the coronary microcirculation for all patients with symptoms and non-obstructive CAD.
AB - Our purpose was to perform a systematic review to assess the prevalence of microvascular angina (MVA) among patients with stable symptoms in the absence of obstructive coronary artery disease (CAD). We performed a systematic review of the literature to group the prevalence of MVA, based on diagnostic pathways and modalities. We defined MVA using three definitions: (i) suspected MVA using non-invasive ischaemia tests; proportion of patients with non-obstructive CAD among patients with symptoms and a positive non-invasive ischaemia test result, (ii) suspected MVA using specific modalities for MVA; proportion of patients with evidence of impaired microvascular function among patients with symptoms and non-obstructive CAD, and (iii) definitive MVA; proportion of patients with positive ischaemia test results among patients with an objectified impaired microvascular dysfunction. We further examined the ratio of women-To-men for the different groups. Of the 4547 abstracts, 20 studies reported data on MVA prevalence. The median prevalence was 43% for suspected MVA using non-invasive ischaemia test, 28% for suspected MVA using specific modalities for MVA, and 30% for definitive MVA. Overall, more women were included in the studies reporting sex-specific data. The women-To-men ratio for included participants was 1.29. However, the average women-To-men ratio for the MVA cases was 2.50. In patients with stable symptoms of ischaemia in the absence of CAD, the prevalences of suspected and definitive MVA are substantial. The results of this study should warrant cardiologists to support, promote and facilitate the comprehensive evaluation of the coronary microcirculation for all patients with symptoms and non-obstructive CAD.
KW - Coronary Artery Disease/diagnosis
KW - Coronary Circulation
KW - Coronary microvascular dysfunction
KW - Female
KW - Humans
KW - Male
KW - Microcirculation
KW - Microvascular Angina/diagnosis
KW - Microvascular angina
KW - Non-obstructive coronary artery disease
KW - Prevalence
KW - Systematic review
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85111595178&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/33677526
UR - http://www.scopus.com/inward/record.url?scp=85111595178&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/cvr/cvab061
DO - https://doi.org/10.1093/cvr/cvab061
M3 - Review article
C2 - 33677526
SN - 0008-6363
VL - 118
SP - 763
EP - 771
JO - Cardiovascular research
JF - Cardiovascular research
IS - 3
ER -