Coronary disease & ACSCohort study
Coronary Vasomotor Dysfunction Is Associated With Cardiovascular Events in Patients With Nonobstructive Coronary Artery Disease
- Cohort study
Authors' conclusion
CVDys phenotype is differentially associated with worse outcomes, and endothelium-dependent and endothelium-independent microvascular function provide independent prognostic information in patients with ANOCA.
Study context
- Population
- Patients with angina and nonobstructive CAD (ANOCA) undergoing coronary reactivity testing with intracoronary Doppler guidewire
- Participants
- 1,196 patients
- Exposure
- Coronary vasomotor dysfunction (CVDys) phenotypes vs no dysfunction
- Outcome
- MACCE:
- CV death
- Nonfatal MI
- HF
- Stroke
- Late revascularization
- Follow-up
- 6.3 years (Q1-Q3: 2.5-12.9 years)
Main finding
As reported in the abstract
MACCE · 6.3 years (Q1-Q3: 2.5-12.9 years)
- Endothelium-dependent microvascular dysfunction vs Without dysfunction: P < 0.001
- Endothelium-dependent epicardial dysfunction vs Without dysfunction: P = 0.038
- Endothelium-independent microvascular dysfunction vs Without dysfunction: P = 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Predictors of MACCE adjusted for conventional risk factors — Coronary flow reserve vs Without dysfunction | 0.757 (0.604–0.957) | |
| Predictors of MACCE adjusted for conventional risk factors — % change in coronary blood flow to Ach vs Without dysfunction | 0.998 (0.996–0.999) | |
| 0.512Hazard ratio (log scale) |
Prevalence of CVDys phenotypes
- Endothelium-independent microvascular dysfunction
- 24.5%
- Endothelium-dependent microvascular dysfunction
- 51.8%
- Endothelium-independent epicardial dysfunction
- 47.4%
- Endothelium-dependent epicardial dysfunction
- 25.4%
Original publication
Coronary Vasomotor Dysfunction Is Associated With Cardiovascular Events in Patients With Nonobstructive Coronary Artery Disease. JACC Cardiovasc Interv. Published 26 February 2024. doi:10.1016/j.jcin.2023.11.039
Summarised from the published abstract; every number is checked against it