Angina pectoris is the medical term for chest pain or discomfort, or tightness due to altered blood circulation — obstruction or stenosis, in the coronary vessels that support the heart. If not detected on time, coronary obstruction causes major heart diseases like stroke, ischaemia and heart attack. Angina affects 30,000 to 40,000 people per million in Western countries. Prevalence increases with age in both men and women. For a population over 65 years old angina occurs in 15% of men and in 12% of women . The standard practice to monitor the status of angina in order to prevent ischaemia is to perform an angiogram. An angiogram is a minimally invasive x-ray procedure performed in a cath lab 3 where a contrast agent is injected into the coronary to visualize their anatomy and asses if plaques are limiting the blood flow to the heart.
CAD or NOCAD ?
1. Blockage in the coronary vessels (epicardial stenosis) that leads to Coronary Artery Disease (CAD). It occurs when the heart muscle doesn't get as much blood as it needs (also called ischaemia), and it usually happens because one or more of the heart's arteries is narrowed or blocked. CAD is now the leading cause of death worldwide. An estimated 3.8M men and 3.4M women die each year from CAD 6.
2. No obstruction or stenosis of the epicardial vessels that is described as Non-Obstructive Coronary Artery Disease (NOCAD). Patients with NOCAD present impairments in the coronary micro-circulation due to coronary microvascular dysfunction (CMD) or vasomotor disorder (non-ability of the vessel to contract/relax). Angina associated with NOCAD, is the women's silent killer, since it affects 50-65% of women and only 33% of men undergoing angiography. Patients with angina associated with NOCAD have historically been considered as low mortality risk; therefore little has been done to find solutions to properly diagnose and treat their disease. Recent clinical studies have shown that patients with angina and NOCAD have a higher risk of major cardiac events, and a 1.5x higher mortality rate compared with the reference population.
Patients with angina associated with NOCAD have a reduced quality of life due to repeated hospitalizations and coronary angiographies, suffering psychological distress 9. Standard tests and current diagnostic tools fail in timely identifying patients with NOCAD and CMD.