Epidemiological and quality of life analysis of patients with ANOCA
DOI:
https://doi.org/10.33448/rsd-v11i17.38891Keywords:
Angina Pectoris; Microvascular Angina; Quality of life.Abstract
Introduction: A portion of patients affected by angina has ANOCA (angina with non-obstructive coronary arteries). Objectives: To determine the epidemiological and quality of life aspects of individuals with angina without coronary obstruction. Material and methods: This is an observational cross-sectional study, conducted by applying questionnaires (SAQ-7 and SF-36) in patients undergoing catheterization in a single hospital from September 2021 to June 2022, and who did not have significant coronary artery obstructions (≥50%). Results: Patients had a mean age of 59.2 years and 60.47% of the sample was female. The main comorbidities found were dyslipidemia (81.4%); hypertension (81.4%); and anxiety (55.81%). Regarding lifestyle habits, 67.44% of patients were sedentary and 34.88% were smokers. According to SAQ-7, for physical limitation, 34.88% patients were in the poor to fair grade. The quality of life had the worst results, with 86.05% of the sample presenting poor to fair. For SF-36, limitations for physical and emotional aspects had median of zero and functional capacity of 25. Discussion: ANOCA patients presented impacts mainly on quality of life, functional capacity, physical limitations, and limitations due to emotional problems, which is in agreement with literature data. Conclusion: Despite de absence of obstructive coronary lesions, patients with ANOCA have significant comorbidities and quality of life impairment, requiring atention from their physicians.
References
Aggarwal, R., Chiu, N., Pankayatselvan, V., Shen, C., & Yeh, R. (2020). Prevalence of angina and use of medical therapy among US adults: A nationally representative estimate. American Heart Journal, 228, 44–46. https://doi.org/10.1016/j.ahj.2020.05.016.
Chan, P. S., Jones, P. G., Arnold, S. A., & Spertus, J. A. (2014). Development and validation of a short version of the seattle angina questionnaire. Circulation: Cardiovascular Quality and Outcomes, 7(5), 640–647. https://doi.org/10.1161/CIRCOUTCOMES.114.000967.
Ferreira, V. M., & Berry, C. (2021). The Health Economics of Ischemia With Nonobstructive Coronary Arteries. JACC: Cardiovascular Imaging, 14(7), 1380–1383. https://doi.org/10.1016/j.jcmg.2021.03.017.
Ford, T. J., Ong, P., Sechtem, U., Beltrame, J., Camici, P. G., Crea, F., et al Kaski, J. C., Bairey Merz, C. N., Pepine, C. J., Shimokawa, H., & Berry, C. (2020). Assessment of Vascular Dysfunction in Patients Without Obstructive Coronary Artery Disease: Why, How, and When. JACC: Cardiovascular Interventions, 13(16), 1847–1864. https://doi.org/10.1016/j.jcin.2020.05.052.
Fu, B., Wei, X., Lin, Y., Chen, J., & Yu, D. (2022). Pathophysiologic Basis and Diagnostic Approaches for Ischemia With Non-obstructive Coronary Arteries: A Literature Review. Frontiers in Cardiovascular Medicine, 9(March), 1–16. https://doi.org/10.3389/fcvm.2022.731059.
Gulati, M., Levy, P. D., Mukherjee, D., Amsterdam, E., Bhatt, D. L., Birtcher, K. K., Blankstein, R., Boyd, J., Bullock-Palmer, R. P., Conejo, T., Diercks, D. B., Gentile, F., Greenwood, J. P., Hess, E. P., Hollenberg, S. M., Jaber, W. A., Jneid, H., Joglar, J. A., Morrow, D. A., … Shaw, L. J. (2021). 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation and Diagnosis of Chest Pain: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. In Circulation (Vol. 144, Issue 22). https://doi.org/10.1161/CIR.0000000000001029.
Jarab, A. S., Almousa, A., Rababa’h, A. M., Mukattash, T. L., & Farha, R. A. (2020). Health-related quality of life and its associated factors among patients with angina in Jordan. Quality of Life Research, 29(4), 1027–1035. https://doi.org/10.1007/s11136-019-02383-7.
Jespersen, L., Abildstrøm, S. Z., Hvelplund, A., & Prescott, E. (2013). Persistent angina: Highly prevalent and associated with long-term anxiety, depression, low physical functioning, and quality of life in stable angina pectoris. Clinical Research in Cardiology, 102(8), 571–581. https://doi.org/10.1007/s00392-013-0568-z.
Jespersen, L., Hvelplund, A., Abildstrøm, S. Z., Pedersen, F., Galatius, S., Madsen, J. K., Jørgensen, E., Kelbæk, H., & Prescott, E. (2012). Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events. European Heart Journal, 33(6), 734–744. https://doi.org/10.1093/eurheartj/ehr331.
Kaski, J. C., Crea, F., Gersh, B. J., & Camici, P. G. (2018). Reappraisal of ischemic heart disease: Fundamental role of coronary microvascular dysfunction in the pathogenesis of angina pectoris. Circulation, 138(14), 1463–1480. https://doi.org/10.1161/CIRCULATIONAHA.118.031373.
Kunadian, V., Chieffo, A., Camici, P. G., Berry, C., Escaned, J., Maas, A. H. E. M., Prescott, E., Karam, N., Appelman, Y., Fraccaro, C., Louise Buchanan, G., Manzo-Silberman, S., Al-Lamee, R., Regar, E., Lansky, A., Abbott, J. D., Badimon, L., Duncker, D. J., Mehran, R., … Baumbach, A. (2020). An EAPCI Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries in Collaboration with European Society of Cardiology Working Group on Coronary Pathophysiology & Microcirculation Endorsed by Coronary Vasomotor Disorders International. European Heart Journal, 41(37), 3504–3520. https://doi.org/10.1093/eurheartj/ehaa503.
Marzilli, M., Crea, F., Morrone, D., Bonow, R. O., Brown, D. L., Camici, P. G., Chilian, W. M., DeMaria, A., Guarini, G., Huqi, A., Merz, C. N. B., Pepine, C., Scali, M. C., Weintraub, W. S., & Boden, W. E. (2020). Myocardial ischemia: From disease to syndrome. International Journal of Cardiology, 314, 32–35. https://doi.org/10.1016/j.ijcard.2020.04.074.
Meeder, J. G., Hartzema-Meijer, M. J., Jansen, T. P. J., Konst, R. E., Damman, P., & Elias-Smale, S. E. (2021). Outpatient Management of Patients With Angina With No Obstructive Coronary Arteries: How to Come to a Proper Diagnosis and Therapy. Frontiers in Cardiovascular Medicine, 8(November), 1–13. https://doi.org/10.3389/fcvm.2021.716319.
Mehta, P. K., Quesada, O., Al-Badri, A., Fleg, J. L., Volgman, A. S., Pepine, C. J., Merz, C. N. B., & Shaw, L. J. (2022). Ischemia and no obstructive coronary arteries in patients with stable ischemic heart disease. International Journal of Cardiology, 348(May 2021), 1–8. https://doi.org/10.1016/j.ijcard.2021.12.013.
Neumann, F. J., Sechtem, U., Banning, A. P., Bonaros, N., Bueno, H., Bugiardini, R., Chieffo, A., Crea, F., Czerny, M., Delgado, V., Dendale, P., Knuuti, J., Wijns, W., Flachskampf, F. A., Gohlke, H., Grove, E. L., James, S., Katritsis, D., Landmesser, U., … Clapp, B. (2020). 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. European Heart Journal, 41(3), 407–477. https://doi.org/10.1093/eurheartj/ehz425.
Patel, M. R., Dai, D., Hernandez, A. F., Douglas, P. S., Messenger, J., Garratt, K. N., Maddox, T. M., Peterson, E. D., & Roe, M. T. (2014). Prevalence and predictors of nonobstructive coronary artery disease identified with coronary angiography in contemporary clinical practice. American Heart Journal, 167(6). https://doi.org/10.1016/j.ahj.2014.03.001.
Perera, D., Berry, C., Hoole, S. P., Sinha, A., Rahman, H., Morris, P. D., Kharbanda, R. K., Petraco, R., & Channon, K. (2022). Invasive coronary physiology in patients with angina and non-obstructive coronary artery disease: A consensus document from the coronary microvascular dysfunction workstream of the British Heart Foundation/National Institute for Health Research Partnershi. Heart, 1–8. https://doi.org/10.1136/heartjnl-2021-320718.
Reynolds, H. R., Picard, M. H., Spertus, J. A., Luis, J., Sendon, L., Senior, R., El-hajjar, M. C., Celutkiene, J., Shapiro, M. D., Pellikka, P. A., Kunichoff, D. F., Anthopolos, R., & Alfakih, K. (2022). HHS Public Access Natural History of Patients with Ischemia and No Obstructive Coronary Artery Disease : the CIAO-ISCHEMIA Study. 144(13), 1008–1023. https://doi.org/10.1161/CIRCULATIONAHA.120.046791.Natural
Schumann, C. L., Mathew, R. C., Dean, J. H. L., Yang, Y., Balfour, P. C., Shaw, P. W., Robinson, A. A., Salerno, M., Kramer, C. M., & Bourque, J. M. (2021). Functional and Economic Impact of INOCA and Influence of Coronary Microvascular Dysfunction. JACC: Cardiovascular Imaging, 14(7), 1369–1379. https://doi.org/10.1016/j.jcmg.2021.01.041.
Villano, A., Lanza, G. A., & Crea, F. (2018). Microvascular angina: Prevalence, pathophysiology and therapy. Journal of Cardiovascular Medicine, 19(suppl 1), E36–E39. https://doi.org/10.2459/JCM.0000000000000638.
Wiśniewski, O. W., Dydowicz, F., Salamaga, S., Skulik, P., Migaj, J., & Kałużna-Oleksy, M. (2022). Risk Factors Predisposing to Angina in Patients with Non-Obstructive Coronary Arteries: A Retrospective Analysis. Journal of Personalized Medicine, 12(7). https://doi.org/10.3390/jpm12071049.
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