Coronary disease & ACSDiagnostic or prognostic study
Rethinking False Positive Exercise Electrocardiographic Stress Tests by Assessing Coronary Microvascular Function
- Diagnostic accuracy study
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% |
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:10.1016/j.jacc.2023.10.034
Summarised from the published abstract; every number is checked against it