Rethinking False Positive Exercise Electrocardiographic Stress Tests by Assessing Coronary Microvascular Function
Authors' conclusion
In patients with ANOCA, ischemia on EST was highly specific of an underlying ischemic substrate.
Study context
- Population
- Patients with angina with nonobstructive coronary arteries (ANOCA) undergoing invasive coronary physiological assessment with adenosine and acetylcholine
- Participants
- 102 patients
- Comparison
- Ischemic vs Nonischemic
- Ischemicn = 32
- Nonischemicn = 70reference
- Outcome
- Specificity of EST (Bruce protocol) for CMD (impaired endothelium-independent and/or endothelium-dependent microvascular function)
Performance
As reported in the abstract
Specificity of ischemia on EST for CMD
| Test or model | Specificity for coronary microvascular dysfunction (CMD) | False positive rate (endothelium-independent and endothelium-dependent reference) |
|---|---|---|
| Electrocardiographic stress testing (EST) | 100% | 0% |
Electrocardiographic stress testing (EST)
Specificity for coronary microvascular dysfunction (CMD)100%
False positive rate (endothelium-independent and endothelium-dependent reference)0%
Further findings
Predictors of ischemia during exercise
- Acetylcholine flow reserve was the strongest predictor of ischemia during exercise
Phenotype of groups
- Both groups phenotypically similar
Original publication
Rethinking False Positive Exercise Electrocardiographic Stress Tests by Assessing Coronary Microvascular Function. J Am Coll Cardiol. Published 16 January 2024. doi:10.
Summarised from the published abstract; every number is checked against it