■冠状动脉痉挛(CAS),包括心外膜和微血管痉挛,越来越多地被认为是非阻塞性冠状动脉疾病(ANOCA)患者心绞痛的原因。然而,使用各种痉挛激发测试方案和诊断标准,使这些患者的诊断和定性变得困难,研究结果的解释也变得繁琐。这篇综述提供了患病率的结构化概述,全球男性和女性CAS的表征和预后。
■进行了一项系统评价,以确定描述患有CAS的ANOCA患者的研究。多种结果(患病率,临床特征,和预后)进行评估。数据,除预后外,采用随机效应荟萃分析模型进行汇总和分析.
■包括25篇出版物(N=14.554)(58.2岁;44.2%的女性)。定义心外膜痉挛的心外膜收缩的百分比范围为>50%至>90%。心外膜痉挛发生率为43%(范围16-73%),在亚洲和亚洲的患病率较高西方世界人口(52%vs.33%,p=0.014)。微血管痉挛发生率为25%(范围7-39%)。男性更容易发生心外膜痉挛(61%),女性更容易出现微血管痉挛(64%).在随访期间经常报告复发性心绞痛,范围为10%至53%。
■CAS在ANOCA患者中非常普遍,男性更经常有心外膜痉挛,女性更常出现微血管痉挛。与西方世界相比,亚洲人群的心外膜痉挛患病率更高。CAS的患病率很高,强调使用明确的研究方案和诊断标准,并强调在患有ANOCA的男性和女性中常规评估CAS的重要性。
■https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=272100。
UNASSIGNED: Coronary artery spasm (CAS), encompassing epicardial and microvascular spasm, is increasingly recognized as cause of angina in patients with non-obstructive coronary artery disease (ANOCA). However, various spasm provocation testing protocols and diagnostic criteria are used, making diagnosis and characterization of these patients difficult and interpretation of study results cumbersome. This
review provides a structured overview of the prevalence, characterization and prognosis of CAS worldwide in men and women.
UNASSIGNED: A systematic
review identifying studies describing ANOCA patients with CAS was performed. Multiple outcomes (prevalence, clinical features, and prognosis) were assessed. Data, except for prognosis were pooled and analysed using random effects meta-analysis models.
UNASSIGNED: Twenty-five publications (N = 14.554) were included (58.2 years; 44.2% women). Percentages of epicardial constriction to define epicardial spasm ranged from >50% to >90%. Epicardial spasm was prevalent in 43% (range 16-73%), with a higher prevalence in Asian vs. Western World population (52% vs. 33%, p = 0.014). Microvascular spasm was prevalent in 25% (range 7-39%). Men were more likely to have epicardial spasm (61%), women were more likely to have microvascular spasm (64%). Recurrent angina is frequently reported during follow-up ranging from 10 to 53%.
UNASSIGNED: CAS is highly prevalent in ANOCA patients, where men more often have epicardial spasm, women more often have microvascular spasm. A higher prevalence of epicardial spasm is demonstrated in the Asian population compared to the Western World. The prevalence of CAS is high, emphasizing the use of unambiguous study protocols and diagnostic criteria and highlights the importance of routine evaluation of CAS in men and women with ANOCA.
UNASSIGNED: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=272100.