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Updates on Pharmacologic Management of Microvascular Angina

Microvascular angina (MVA), historically called cardiac syndrome X, refers to angina with nonobstructive coronary artery disease. This female-predominant cardiovascular disorder adds considerable health-related costs due to repeated diagnostic angiography and frequent hospital admissions. Despite th...

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Autores principales: Soleymani, Mosayeb, Masoudkabir, Farzad, Shabani, Mahsima, Vasheghani-Farahani, Ali, Behnoush, Amir Hossein, Khalaji, Amirmohammad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9626221/
https://www.ncbi.nlm.nih.gov/pubmed/36382021
http://dx.doi.org/10.1155/2022/6080258
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author Soleymani, Mosayeb
Masoudkabir, Farzad
Shabani, Mahsima
Vasheghani-Farahani, Ali
Behnoush, Amir Hossein
Khalaji, Amirmohammad
author_facet Soleymani, Mosayeb
Masoudkabir, Farzad
Shabani, Mahsima
Vasheghani-Farahani, Ali
Behnoush, Amir Hossein
Khalaji, Amirmohammad
author_sort Soleymani, Mosayeb
collection PubMed
description Microvascular angina (MVA), historically called cardiac syndrome X, refers to angina with nonobstructive coronary artery disease. This female-predominant cardiovascular disorder adds considerable health-related costs due to repeated diagnostic angiography and frequent hospital admissions. Despite the high prevalence of this diagnosis in patients undergoing coronary angiography, it is still a therapeutic challenge for cardiologists. Unlike obstructive coronary artery disease, with multiple evidence-based therapies and management guidelines, little is known regarding the management of MVA. During the last decade, many therapeutic interventions have been suggested for the treatment of MVA. However, there is a lack of summarization tab and update of current knowledge about pharmacologic management of MVA, mostly due to unclear pathophysiology. In this article, we have reviewed the underlying mechanisms of MVA and the outcomes of various medications in patients with this disease. Contrary to vasospastic angina in which normal angiogram is observed as well, nitrates are not effective in the treatment of MVA. Beta-blockers and calcium channel blockers have the strongest evidence of improving the symptoms. Moreover, the use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, statins, estrogen, and novel antianginal drugs has had promising outcomes. Investigations are still ongoing for vitamin D, omega-3, incretins, and n-acetyl cysteine, which have resulted in beneficial initial outcomes. We believe that the employment of the available results and results of the future large-scale trials into cardiac care guidelines would help reduce the global cost of cardiac care tremendously.
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spelling pubmed-96262212022-11-14 Updates on Pharmacologic Management of Microvascular Angina Soleymani, Mosayeb Masoudkabir, Farzad Shabani, Mahsima Vasheghani-Farahani, Ali Behnoush, Amir Hossein Khalaji, Amirmohammad Cardiovasc Ther Review Article Microvascular angina (MVA), historically called cardiac syndrome X, refers to angina with nonobstructive coronary artery disease. This female-predominant cardiovascular disorder adds considerable health-related costs due to repeated diagnostic angiography and frequent hospital admissions. Despite the high prevalence of this diagnosis in patients undergoing coronary angiography, it is still a therapeutic challenge for cardiologists. Unlike obstructive coronary artery disease, with multiple evidence-based therapies and management guidelines, little is known regarding the management of MVA. During the last decade, many therapeutic interventions have been suggested for the treatment of MVA. However, there is a lack of summarization tab and update of current knowledge about pharmacologic management of MVA, mostly due to unclear pathophysiology. In this article, we have reviewed the underlying mechanisms of MVA and the outcomes of various medications in patients with this disease. Contrary to vasospastic angina in which normal angiogram is observed as well, nitrates are not effective in the treatment of MVA. Beta-blockers and calcium channel blockers have the strongest evidence of improving the symptoms. Moreover, the use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, statins, estrogen, and novel antianginal drugs has had promising outcomes. Investigations are still ongoing for vitamin D, omega-3, incretins, and n-acetyl cysteine, which have resulted in beneficial initial outcomes. We believe that the employment of the available results and results of the future large-scale trials into cardiac care guidelines would help reduce the global cost of cardiac care tremendously. Hindawi 2022-10-25 /pmc/articles/PMC9626221/ /pubmed/36382021 http://dx.doi.org/10.1155/2022/6080258 Text en Copyright © 2022 Mosayeb Soleymani et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Soleymani, Mosayeb
Masoudkabir, Farzad
Shabani, Mahsima
Vasheghani-Farahani, Ali
Behnoush, Amir Hossein
Khalaji, Amirmohammad
Updates on Pharmacologic Management of Microvascular Angina
title Updates on Pharmacologic Management of Microvascular Angina
title_full Updates on Pharmacologic Management of Microvascular Angina
title_fullStr Updates on Pharmacologic Management of Microvascular Angina
title_full_unstemmed Updates on Pharmacologic Management of Microvascular Angina
title_short Updates on Pharmacologic Management of Microvascular Angina
title_sort updates on pharmacologic management of microvascular angina
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9626221/
https://www.ncbi.nlm.nih.gov/pubmed/36382021
http://dx.doi.org/10.1155/2022/6080258
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