Current Overview of Diagnostic and Treatment Strategies for Ischemia with Non-obstructive Coronary Artery Disease

Abstract

Myocardial ischemia is known to occur even in the absence of coronary artery stenosis. Ischemia with nonobstructive coronary artery disease (INOCA) was first defined in 2017. Since then, several studies have been conducted, and consensuses and guidelines have been reported on the treatment and management of INOCA. Numerous studies have examined coronary spasm/vasospastic angina (CSA/VSA) and coronary microvascular dysfunction (CMD), resulting in the current consensus concerning the management and treatment of INOCA. However, several unsolved problems still exist. We herein review the definition, pathology, epidemiology, diagnosis, treatment, management, and perspectives of INOCA.