Coronary disease & ACSCross-sectional study
Angiographic Coronary Slow Flow Is Not a Valid Surrogate for Invasively Diagnosed Coronary Microvascular Dysfunction
- Cross-sectional study
Authors' conclusion
Coronary slow flow was weakly associated with results of invasive CFT and should not be used as a surrogate for the invasive diagnosis of CMD.
Study context
- Population
- Adults with ischemia with no obstructive coronary arteries undergoing invasive coronary function testing
- Participants
- 508 adults
- Exposure
- Coronary slow flow vs no slow flow
- Outcome
- Relationships between cTFC and invasive coronary function testing (CFT) for CMD (abnormal CFR <2.5 and/or abnormal IMR ≥25)
Main finding
Invasive measures of CMD by slow flow
Adjusted odds ratio
0.53
95% CI 0.35–0.80
By group
Slow flow
36%
Abnormal index of microcirculatory resistance (IMR) · Abnormal coronary flow reserve (CFR) 28% · coronary microvascular dysfunction (CMD) 46%
No slow flow
26%
Abnormal IMR · Abnormal CFR 42% · CMD 51%
Slow flow vs No slow flow
adjusted OR 0.53 (95% CI 0.35–0.80)
As reported in the abstract
- Abnormal IMR, slow flow vs no slow flow
- P = 0.019
- Abnormal CFR, slow flow vs no slow flow
- P = 0.001
- Coronary slow flow prevalence
- 49%
Observational data: associations, not effects.
Further findings
Correlation of cTFC with invasive measures
- cTFC vs baseline coronary blood flow, r =
- −0.35 (95% CI: −0.42 to −0.27)
- cTFC vs CFR, r =
- 0.20 (95% CI: 0.12 to 0.28)
- cTFC vs IMR, r =
- 0.16 (95% CI: 0.07-0.24)
- weak correlations
Original publication
Angiographic Coronary Slow Flow Is Not a Valid Surrogate for Invasively Diagnosed Coronary Microvascular Dysfunction. JACC Cardiovasc Interv. Published 8 April 2024. doi:10.1016/j.jcin.2024.02.025
Summarised from the published abstract; every number is checked against it