Ischaemia with no obstructive coronary arteries: a review with focus on the Asian population

• Published in: Singapore medical journal Vol. 65; no. 7; pp. 380 - 388
• Main Authors: Soh, Rodney Yu-Hang, Low, Ting-Ting, Sia, Ching-Hui, Kong, William Kok-Fai, Yeo, Tiong-Cheng, Loh, Poay-Huan, Poh, Kian-Keong
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer - Medknow 01.07.2024; Medknow Publications and Media Pvt. Ltd; Wolters Kluwer – Medknow Publications
• Edition: 2
• Subjects: Arteries; Asian People; Care and treatment; Coronary Angiography; coronary artery disease; Coronary Artery Disease - diagnosis; Coronary heart disease; Coronary Vessels; functional coronary artery assessment; Health aspects; Humans; ischaemia with no obstructive coronary arteries; ischaemic heart disease; Ischemia; Ivabradine; Medical care, Cost of; Myocardial Ischemia - epidemiology; Prevalence; Prognosis; Quality of Life; Review; Review Article; Risk Factors; Asia; functional coronary artery assessment; ischaemic heart disease; Coronary artery disease; ischaemia with no obstructive coronary arteries
• ISSN: 0037-5675; 2737-5935
• DOI: 10.4103/singaporemedj.SMJ-2023-116

Abstract Ischaemia with no obstructive coronary arteries (INOCA) has been a diagnostic and therapeutic challenge for decades. Several studies have demonstrated that INOCA is associated with an increased risk of death, adverse cardiovascular events, poor quality of life and high healthcare cost. Although there is increasing recognition of this entity in the Western population, in the Asian population, INOCA remains elusive and its prevalence uncertain. Despite its prognostic significance, diagnosis of INOCA is often delayed. In this review, we identified the multiple barriers to its diagnosis and management, and proposed strategies to overcome them.