Abstract

Chronic low-grade inflammation has a role in coronary atherosclerosis, resulting in a variety of clinical symptoms such as asymptomatic to stable angina, acute coronary syndrome, heart failure, and sudden cardiac death. Coronary microvasculature is made up of vessels with a diameter of less than 500 m, and structural and functional problems can cause inappropriate dilatation and an inability to fulfil myocardial oxygen needs. This review focuses on the pathophysiology of coronary microvascular dysfunction and the detection potential of non-invasive screening approaches. Anti-inflammatory agents such as statins and immunomodulators such as anakinra, tocilizumab, and tumour necrosis factor-alpha inhibitors have recently been studied and may represent additional or alternative treatment approaches to reduce cardiovascular events in atherosclerotic heart disease with coronary microvascular dysfunction.