SPC365

Coronary physiology in in patients with angina and non-obstructive coronary artery disease - preliminary data from multicenter registry.

Session: SESSÃO DE POSTERS 40 - INTERVENÇÃO CORONÁRIA
Speaker: Mariana Carvalho

Congress: CPC 2025
Topic: H. Interventional Cardiology and Cardiovascular Surgery
Theme: 25. Interventional Cardiology
Subtheme: 25.1 Invasive Imaging and Functional Assessment
Session Type: Cartazes
FP Number: ---
Authors: Mariana Ferreira Carvalho; Margarida Cabral; Carolina Gonçalves; Adriana Vazão; André Martins; Mónica Amado; Joana Pereira; Francisco Soares; Pedro Jerónimo Sousa; Fátima Saraiva; Jorge Guardado; Manuel de Oliveira Santos

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-family:Arial,sans-serif"><span style="color:black">Introduction: </span></span></strong></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:Arial,sans-serif"><span style="color:black">Coronary vasomotion disorders (CVDs) are a common cause of angina and ischemia in patients with non-obstructive coronary artery disease (ANOCA/INOCA). However, invasive coronary angiography (ICA) often falls short in identifying vasospastic angina and microvascular dysfunction. The role of CVD as the cause of angina or ischemia is becoming increasingly recognized.</span></span></span></span></span></p>

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<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-family:Arial,sans-serif">Purpose</span></strong></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:Arial,sans-serif">We aimed to characterize coronary physiology and microvascular function in patients with angina or ischemia and non-obstructive coronary artery disease (ANOCA/INOCA). </span></span></span></span></p>

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<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-family:Arial,sans-serif">Methods</span></strong></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:Arial,sans-serif">We included in this retrospective study individuals diagnosed with ANOCA/INOCA who underwent in our coronary function testing (CFT) protocol from July 2022 to January 2023 across multiple centers. The assessment involved invasive examinations of coronary circulation vasorelaxation both at rest and during hyperemia induced by adenosine. Additionally, we evaluated the propensity for coronary vasospasm by administering increasing doses of intra-coronary acetylcholine. Recorded data included fractional flow reserve, coronary flow reserve (CFR), and the index of microvascular resistance (IMR). The diagnosis of cardiovascular disorders (CVDs) followed the criteria outlined by the Coronary Vasomotor Disorders International Study Group.&nbsp; </span></span></span></span></p>

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<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-family:Arial,sans-serif">Results</span></strong></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:Arial,sans-serif">In this study, a total of 32 patients were enrolled, with an average age of 63.1 &plusmn; 8.4 years, and 56.3% were female. The most prevalent cardiovascular risk factors were dyslipidemia (68.8%), arterial hypertension (55.1%), and diabetes mellitus (39%). At the outset, all patients exhibited either typical angina (59.4%, n=19) or a positive ischemia test (68.7%, n=22). Of the participants, 21 individuals (65.6%) had previously undergone invasive coronary angiography or computed tomography due to anginal symptoms. The implementation of our coronary function testing (CFT) protocol was successfully completed in all patients without encountering any serious complications. The results revealed isolated macrovascular vasospasm in 15 patients (46.9%), isolated coronary microvascular dysfunction (CMD) in 6 patients (18.8%), and a combination of CMD and coronary vasospasm in 2 patients (6.3. A normal result was observed in 9 patients (28.1%).</span></span></span></span></p>

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<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-family:Arial,sans-serif">Conclusion</span></strong></span></span></span></p>

<p style="text-align:start"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><span style="font-family:Arial,sans-serif">Coronary vasomotion disorders emerge as a prevalent diagnosis, being present in 71.9% of patients referred for coronary angiography with coronary physiology with diagnosis of INOCA/ANOCA. </span></span></span></span></p>