Myocardial ischemia: From disease to syndrome - PubMed (original) (raw)

doi: 10.1016/j.ijcard.2020.04.074. Epub 2020 Apr 26.

Filippo Crea 2, Doralisa Morrone 3, Robert O Bonow 4, David L Brown 5, Paolo G Camici 6, William M Chilian 7, Anthony DeMaria 8, Giacinta Guarini 3, Alda Huqi 3, C Noel Bairey Merz 9, Carl Pepine 10, Maria Chiara Scali 3, William S Weintraub 11, William E Boden 12

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Myocardial ischemia: From disease to syndrome

Mario Marzilli et al. Int J Cardiol. 2020.

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Abstract

Although current guidelines on the management of stable coronary artery disease acknowledge that multiple mechanisms may precipitate myocardial ischemia, recommended diagnostic, prognostic and therapeutic algorithms are still focused on obstructive epicardial atherosclerotic lesions, and little progress has been made in identifying management strategies for non-atherosclerotic causes of myocardial ischemia. The purpose of this consensus paper is three-fold: 1) to marshal scientific evidence that obstructive atherosclerosis can co-exist with other mechanisms of ischemic heart disease (IHD); 2) to explore how the awareness of multiple precipitating mechanisms could impact on pre-test probability, provocative test results and treatment strategies; and 3) to stimulate a more comprehensive approach to chronic myocardial ischemic syndromes, consistent with the new understanding of this condition.

Keywords: Angina; Chronic coronary syndromes; Coronary artery disease; Ischemic heart disease; Microvascular dysfunction.

Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.

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Conflict of interest statement

Declaration of competing interest The authors report no relationships that could be construed as a conflict of interest.

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