Coronary disease & ACSCohort study
Microvascular Resistance Reserve vs Coronary Flow Reserve to Assess Age-Related Trends in Coronary Microvascular Dysfunction
- Registry-based cohort study
Authors' conclusion
Structural CMD increases with age regardless of obstructive CAD, while functional CMD prevalence increases only in nonobstructive CAD.
Study context
- Population
- Patients with stable angina in the ILIAS Registry, obstructive (FFR ≤0.80) and nonobstructive (FFR >0.80) lesions
- Participants
- 1,704 patients · 2,283 lesions
- Exposure
- Microvascular resistance reserve (MRR) vs coronary flow reserve (CFR) for coronary microvascular dysfunction (CMD) classification across age strata
- Outcome
- Prevalence of CMD endotypes (no, functional, structural CMD) by age strata; CFR vs MRR for diagnosis
Main finding
As reported in the abstract
CMD prevalence by MRR across age strata
- Overall CMD prevalence by MRR
- 48.2%
- CMD by MRR increased across age strata (<50 to ≥80)
- 37.2% to 78.0%; P < 0.001
- Structural CMD increased across age strata
- 10.9% to 40.0%; P < 0.001
- Functional CMD unchanged across age strata
- 26.3% to 38.0%; P = 0.220
- Age independently predicted functional CMD (OR/y)
- 1.02; P < 0.001
- Age independently predicted structural CMD (OR/y)
- 1.05; P < 0.001
- CMD prevalence by CFR vs MRR, irrespective of epicardial disease
- 53.3% vs 48.2%; P < 0.001
Observational data: associations, not effects.
Further findings
Age as predictor of CMD, obstructive lesions (subgroup)
- Structural CMD (OR/y)
- 1.03; P = 0.0055
Age as predictor of CMD, nonobstructive lesions (subgroup)
- Functional CMD (OR/y)
- 1.02; P = 0.0032
- Structural CMD (OR/y)
- 1.06; P < 0.001
Original publication
Microvascular Resistance Reserve vs Coronary Flow Reserve to Assess Age-Related Trends in Coronary Microvascular Dysfunction. JACC Cardiovasc Interv. Published 9 January 2026. doi:10.1016/j.jcin.2025.11.019
Summarised from the published abstract; every number is checked against it