Coronary disease & ACSCross-sectional study
Multiple Endotypes and Angina Burden in Patients With Nonobstructive Coronary Arteries
- Cross-sectional study
- single-centre
Authors' conclusion
In this observational cross-sectional study, multiple endotypes frequently coexisted in patients with ANOCA, and a greater number of endotypes identified on CFT was associated with worse angina.
Study context
- Population
- Patients with suspected angina with nonobstructive coronary arteries (ANOCA) undergoing comprehensive coronary function testing (acetylcholine, adenosine, intravascular ultrasound for myocardial bridge), Stanford Hospital, 2007–2025
- Participants
- 485 patients
- Exposure
- Number of ANOCA endotypes on comprehensive coronary function testing (CFT)
- Normal CFTn = 36reference
- 1 endotypen = 150
- 2 endotypesn = 215
- 3 endotypesn = 84
- Outcome
- Association between number of ANOCA endotypes and angina burden (SAQ)
Main finding
SAQ summary score
B
−3.55
95% CI −5.56 to −1.54
P < 0.001
By group
Normal CFT
55.9
mean · SD 17.6
1 endotype
53.8
mean · SD 17.7
2 endotypes
51.2
mean · SD 18.3
3 endotypes
45.7
mean · SD 20.0
As reported in the abstract
- Trend across number of endotypes
- P = 0.003
Observational data: associations, not effects.
Further findings
Mean
| Outcome | Endothelium-dependent abnormality | Endothelium-independent abnormality | Myocardial bridging |
|---|---|---|---|
| SAQ summary score by endotype type | 50.5 (SD 18.3) | 49.3 (SD 19.9) | 49.8 (SD 19.2) |
Seattle Angina Questionnaire (SAQ) summary score by endotype type
- Comparable among endotype types
Original publication
Multiple Endotypes and Angina Burden in Patients With Nonobstructive Coronary Arteries. JAMA Cardiol. Published 1 July 2026. doi:10.1001/jamacardio.2026.1234
Summarised from the published abstract; every number is checked against it