Summary
This 2023 Japanese clinical guideline provides an updated evidence synthesis on the diagnosis and treatment of vasospastic angina and coronary microvascular dysfunction, representing consensus from the Japanese Circulation Society and related cardiology bodies. The guideline appears to consolidate current understanding of pathophysiological mechanisms, diagnostic modalities, and pharmacological management strategies for these conditions, which represent important causes of angina with angiographically normal or minimally diseased coronary arteries. As a practitioner-facing clinical guideline rather than a mechanistic research study, it serves primarily to harmonise clinical decision-making across Japanese healthcare settings.
UK applicability
UK cardiologists may find utility in the diagnostic algorithms and treatment hierarchies presented, though guideline recommendations should be contextualised within UK National Institute for Health and Care Excellence (NICE) frameworks and local clinical pathways. The pathophysiological insights may inform similar guideline development in the United Kingdom, particularly regarding recognition and management of non-obstructive coronary artery disease.
Key measures
Diagnostic algorithms for coronary vasospasm and microvascular dysfunction; treatment efficacy outcomes; risk stratification criteria; symptom management protocols
Outcomes reported
The guideline addresses clinical diagnostic criteria, pathophysiological mechanisms, and evidence-based treatment approaches for vasospastic angina and coronary microvascular dysfunction. The update synthesises recommendations from Japanese cardiology societies on risk stratification, pharmacological and non-pharmacological interventions.
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