Nonobstructive Coronary Artery Disease in Women:Risk Factors and Noninvasive Diagnostic Assessment

(整期优先)网络出版时间:2019-07-10
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Sex-specificdifferencesintheepidemiologyandpathophysiologyofcoronaryarterydiseaseandischemicheartdiseasearenowwellrecognized.Womenwithanginamoreoftenhavenonobstructivecoronaryarterydisease(NOCAD)comparedwithmen.Thispatientpopulationcarriesasignificantriskoffuturecardiovasculareventsthatisnotcommonlyappreciated,oftenleadingtodelayeddiagnosisandtreatment.WhilecoronarymicrovasculardysfunctionplaysacentralroleinthepathophysiologyofNOCADinwomen,othermechanismsofmyocardialischemiaarenowrecognized.RiskfactorssuchashypertensionandobesitydisparatelyaffectwomenandarelikelytoaccountforasignificantproportionofNOCADinthecomingyears.VascularinflammationisanimportantpathophysiologicpathwayinNOCADandisapotentialtherapeutictarget.CoronaryCTangiographyprovidesacomprehensiveassessmentofcoronaryanatomyandplaquemorphologyandisareasonablescreeningtestofchoiceforNOCAD.