ANMCO POSITION PAPER: Prognostic and therapeutic relevance of non-obstructive coronary atherosclerosis

Author:

Casolo Giancarlo1,Gabrielli Domenico2,Colivicchi Furio3,Murrone Adriano4,Grosseto Daniele5,Gulizia Michele Massimo67,Di Fusco Stefania3,Domenicucci Stefano8,Scotto di Uccio Fortunato9,Di Tano Giuseppe10,Orso Francesco11,Grippo Gabriele12,Abrignani Maurizio13,Valente Serafina14,Corda Marco15

Affiliation:

1. Cardiology Department, Ospedale Versilia, Lido di Camaiore (LU), Via Aurelia 335, 55041 Lido di Camaiore, Italy

2. Cardiology-CCU Department, Azienda Ospedaliera San Camillo Forlanini, Roma, Italy

3. Clinical and Rehabilitation Cardiology Department, Presidio Ospedaliero San Filippo Neri, ASL Roma 1, Roma, Italy

4. Cardiology Department, Ospedali di Castello e Gubbio-Gualdo Tadino, Azienda USL Umbria 1, Perugia, Italy

5. Cardiology Department, Ospedale di Rimini, Rimini, Italy

6. Cardiology Department, Ospedale Garibaldi-Nesima, Azienda di rilievo Nazionale e Alta Specializzazione “Garibaldi”, Catania, Italy

7. Fondazione per il Tuo Cuore, Heart Care Foundation, Via la Marmora 36, Florence, Italy

8. Cardiology Department, USL 3, Genova, Italy

9. Cardiology-ICU Department, Cath Lab, Ospedale del Mare, Napoli, Italy

10. Cardiology Department, ASST di Cremona, Ospedale Cremona, Italy

11. Cardiology and Geriatric Medicine Department, AOU Careggi, Firenze, Italy

12. Cardiology Department, Ospedale di Prato, Prato, Italy

13. Cardiology Department, P.O. S. Antonio Abate, Trapani, Italy

14. Clinical-Surgical Cardiology and ICU Department, Ospedale Santa Maria alle Scotte, Siena, A.O.U. Senese, Italy

15. Cardiology Department, Azienda Ospedaliera G. Brotzu, Cagliari, Italy

Abstract

Abstract Atherosclerosis often affects the coronary arterial tree. Frequently the disease does not translate in significant narrowing of the vessels, thus determining only a non-obstructive disease. This condition that is described as non-obstructive coronary artery disease (NobsCAD) should be distinguished from the absence of disease (i.e. smooth coronary arteries) as it carries a specific prognostic value. The detection and reporting of NobsCAD should prompt preventive measures that can be individualized upon the degree of the underlying burden of disease. The accompanying clinical condition, the other cardiovascular risk factors present, and the description of the severity and extent of NobsCAD should provide the framework for an individualized treatment that should also consider the best available scientific evidence and guidelines. The description of NobsCAD represents important information to be collected whenever a coronary angiogram (both invasive and non-invasive) is performed. Treating the patient according to the presence and extent of NobsCAD offers prognostic benefits well beyond those offered by considering only the traditional cardiovascular risk factors. In order to reach this goal, NobsCAD should not be confused with the absence of coronary atherosclerosis or even ignored when detected as if it was a trivial information to provide.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

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