Targeted Therapies for Microvascular Disease

Adam Bland; Eunice Chuah; William Meere; Thomas J Ford

doi:10.1016/j.ccl.2023.07.002

Targeted Therapies for Microvascular Disease

Cardiol Clin. 2024 Feb;42(1):137-145. doi: 10.1016/j.ccl.2023.07.002.

Authors

Adam Bland¹, Eunice Chuah¹, William Meere¹, Thomas J Ford²

Affiliations

¹ Department of Cardiology, Gosford Hospital - Central Coast LHD, 75 Holden Street, Gosford, New South Wales 2250, Australia; The University of Newcastle, University Dr, Callaghan, New South Wales 2308, Australia.
² Department of Cardiology, Gosford Hospital - Central Coast LHD, 75 Holden Street, Gosford, New South Wales 2250, Australia; The University of Newcastle, University Dr, Callaghan, New South Wales 2308, Australia; University of Glasgow, ICAMS, G12 8QQ Glasgow, UK. Electronic address: Tom.ford@health.nsw.gov.au.

PMID: 37949535
DOI: 10.1016/j.ccl.2023.07.002

Abstract

Coronary microvascular dysfunction (CMD) is a common cause of ischemia but no obstructive coronary artery disease that results in an inability of the coronary microvasculature to meet myocardial oxygen demand. CMD is challenging to diagnose and manage due to a lack of mechanistic research and targeted therapy. Recent evidence suggests we can improved patient outcomes by stratifying antianginal therapies according to the diagnosis revealed by invasive assessment of the coronary microcirculation. This review article appraises the evidence for management of CMD, which includes treatment of cardiovascular risk, antianginal therapy and therapy for atherosclerosis.

Keywords: Angina; CMD; INOCA; Ischemia; Management.

Publication types

Review

MeSH terms

Coronary Artery Disease* / complications
Coronary Circulation
Coronary Vessels
Heart Disease Risk Factors
Humans
Myocardial Ischemia* / drug therapy
Myocardium