{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:29:32Z","timestamp":1792427372067,"version":"4.5.0"},"reference-count":80,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,4,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">A relevant proportion of patients with suspected coronary artery disease undergo invasive coronary angiography showing normal or nonobstructive coronary arteries. However, the prevalence of coronary microvascular disease (CMD) and coronary spasm in patients with nonobstructive coronary artery disease remains to be determined. The objective of this study was to determine the prevalence of coronary CMD and coronary vasospastic angina in patients with no obstructive coronary artery disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">A systematic review and meta\u2010analysis of studies assessing the prevalence of CMD and vasospastic angina in patients with no obstructive coronary artery disease was performed. Random\u2010effects models were used to determine the prevalence of these 2 disease entities. Fifty\u2010six studies comprising 14 427 patients were included. The pooled prevalence of CMD was 0.41 (95% CI, 0.36\u20130.47), epicardial vasospasm 0.40 (95% CI, 0.34\u20130.46) and microvascular spasm 24% (95% CI, 0.21\u20130.28). The prevalence of combined CMD and vasospastic angina was 0.23 (95% CI, 0.17\u20130.31). Female patients had a higher risk of presenting with CMD compared with male patients (risk ratio, 1.45 [95% CI, 1.11\u20131.90]). CMD prevalence was similar when assessed using noninvasive or invasive diagnostic methods.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In patients with no obstructive coronary artery disease, approximately half of the cases were reported to have CMD and\/or coronary spasm. CMD was more prevalent among female patients. Greater awareness among physicians of ischemia with no obstructive coronary arteries is urgently needed for accurate diagnosis and patient\u2010tailored management.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.023207","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T11:05:05Z","timestamp":1647601505000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":228,"title":["Prevalence of Coronary Microvascular Disease and Coronary Vasospasm in Patients With Nonobstructive Coronary Artery Disease: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4666-0181","authenticated-orcid":false,"given":"Niya","family":"Mileva","sequence":"first","affiliation":[{"name":"Cardiovascular Center Aalst OLV Hospital Aalst Belgium"},{"name":"Cardiology Clinic Alexandrovska University Hospital Sofia 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