Goal 2: Reduce Human Disease

Non-obstructive Coronary Disease

It is increasingly apparent that ischemic heart disease does not equal obstructive coronary disease. There is a large, heterogeneous population of individuals who present to the ED with chest pain syndrome with or without a troponin elevation, who on diagnostic evaluation have non-obstructive disease and who on prospective studies have increased risk for ACS and early mortality; other literature shows the same for coronary microvascular disease. Needed is research to, 1) characterize distinct patient groups, and 2) identify key aspects of pathophysiology, including vascular and autonomic features, and using ecological methods, environmental precipitants, including the psycho-social domain.

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Idea No. 432