Loading...
Publication
Initial Single-Center Experience of a Standardized Protocol for Invasive Assessment of Ischemia and Non-Obstructive Coronary Artery Disease
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 2.81 MB | Adobe PDF |
Advisor(s)
Abstract(s)
Introduction: Coronary vasomotion disorders (CVDs), including microvascular angina (MVA) and vasospastic angina (VSA), account for significant morbidity among patients with non-obstructive coronary artery disease (NOCAD). However, protocols for CVD assessment in clinical practice are seldom standardized and may be difficult to implement.
Purpose: To assess the safety and feasibility of a comprehensive coronary function test (CFT) protocol for assessment of CVD and the prevalence of different phenotypes of CVD in patients with angina and NOCAD (ANOCA).
Methods: Patients with persistent angina referred for invasive coronary angiogram and found to have NOCAD were prospectively recruited and underwent a CFT. Functional parameters (fractional flow reserve, coronary flow reserve and index of myocardial resistance) and coronary vasoreactivity were assessed in all patients.
Results: Of the 20 patients included, the mean age was 63±13 years and 50% were females. Most patients had persistent typical angina and evidence of ischemia in noninvasive tests (75%). The CFT was successfully performed in all subjects without serious complications. Isolated MVA was found in 25%, isolated VSA in 40%, both MVA and VSA in 10% and noncardiac chest pain in 25% of patients. Antianginal therapy was modified after the results of CFT in 70% of patients.
Conclusion: A coronary function test was feasible and safe in a cohort of patients with ANOCA. CVD were prevalent in this selected group of patients, and some presented mixed CVD phenotypes. CFT may provide a definitive diagnosis in patients with persistent angina and prompt the stratification of pharmacological therapy.
Description
Keywords
HSM CAR Humans Female Male Coronary Angiography Coronary Artery Disease* / diagnosis Coronary Vessels Fractional Flow Reserve, Myocardial* Ischemia Microvascular Angina* / diagnosis Microvascular Angina* / epidemiology
Citation
Rev Port Cardiol . 2023 May;42(5):455-465.