Coronary Function Testing in Patients with Angina but No Obstructive Coronary Disease

Clinical Takeaway

: Testing was both safe and effective in a recent trial, with subsequent tailored therapy leading to improved angina at 6 months.

Context

Angina with nonobstructive coronary arteries (ANOCA) is an increasingly recognized syndrome in which patients experience anginal chest pain despite the absence of obstructive coronary disease on angiography. These patients may have coronary microvascular dysfunction and/or coronary spasm, both of which can be detected through coronary function testing (CFT; intracoronary infusion of adenosine and acetylcholine) during angiography.

To examine CFT’s efficacy and safety in this setting, researchers identified 153 patients with ANOCA who were undergoing CFT and randomized them to a control group (in which the test results remained blinded) or an intervention group (in which the results were disclosed and used to tailor medical therapy).