SynthesisJACC. Cardiovascular imaging2015
Coronary microvascular dysfunction, microvascular angina, and treatment strategies.
Synthesis in JACC. Cardiovascular imaging, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 150 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
150 citing papers in PubMed, 7 syntheses or guidelines pooled it, 297 citations in OpenAlex.
- The Relationship of Coronary Microvascular Dysfunction and Left Ventricular Systolic and Diastolic Dysfunction: A Systematic Review and Meta-Analysis.Echocardiography (Mount Kisco, N.Y.) · 2026Pooled it
- Shedding Light on Treatment Options for Coronary Vasomotor Disorders: A Systematic Review.Cardiovascular drugs and therapy · 2024Pooled it
- Diagnostic and prognostic value of angiography-derived index of microvascular resistance: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2024Pooled it
- Evaluation of non-invasive imaging parameters in coronary microvascular disease: a systematic review.BMC medical imaging · 2021Pooled it
- Association of Isolated Coronary Microvascular Dysfunction With Mortality and Major Adverse Cardiac Events: A Systematic Review and Meta-Analysis of Aggregate Data.Journal of the American Heart Association · 2020Pooled it
- Effects of Oral Drugs on Coronary Microvascular Function in Patients Without Significant Stenosis of Epicardial Coronary Arteries: A Systematic Review and Meta-Analysis of Coronary Flow Reserve.Frontiers in cardiovascular medicine · 2020Pooled it
- Expert consensus document: A 'diamond' approach to personalized treatment of angina.Nature reviews. Cardiology · 2018Guideline
- Trial
- Interplay Between Systemic Inflammation, Myocardial Injury, and Coronary Microvascular Dysfunction in Rheumatoid Arthritis: Results From the LiiRA Study.Journal of the American Heart Association · 2024Trial
- Primary versus iatrogenic (post-PCI) coronary microvascular dysfunction: a wire-based multimodal comparison.Open heart · 2023Trial
- Systemic microvascular dysfunction in microvascular and vasospastic angina.European heart journal · 2018Trial
- Trial
- Ranolazine and Microvascular Angina by PET in the Emergency Department: Results From a Pilot Randomized Controlled Trial.Clinical therapeutics · 2017Trial
- Article
- Clinical Significance of High-Sensitivity Cardiac Troponin I and Myoglobin in Patients with Suspected Coronary Microvascular Dysfunction.Journal of cardiovascular translational research · 2026Article
- Coronary Flow Reserve in Adults: Pathophysiology, Assessment Modalities, Clinical Applications, and Prognostic Significance.Medicina (Kaunas, Lithuania) · 2026Review
- Cardiac involvement in systemic sclerosis: mechanisms, manifestations and management.Rheumatology (Oxford, England) · 2026Review
- Aortic pressure-velocity loop: a potential tool for assessing risk associated with midsystolic forward compression waves in patients with chronic atherosclerotic coronary artery disease.American heart journal plus : cardiology research and practice · 2026Article
- Transient cavity dilatation during supine exercise bicycle stress testing: mechanistic insights.Echo research and practice · 2026Article
- Use of a Novel, Self-Expanding Coronary Sinus Reducer to Treat Symptomatic Epicardial and Microvascular Ischemic Heart Disease: Preclinical and First-in-Human Experience.Journal of the Society for Cardiovascular Angiography & Interventions · 2026Article
90 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
Angina without coronary artery disease (CAD) has substantial morbidity and is present in 10% to 30% of patients undergoing angiography. Coronary microvascular dysfunction (CMD) is present in 50% to 65% of these patients. The optimal treatment of this cohort is undefined. We performed a systematic review to evaluate treatment strategies for objectively-defined CMD in the absence of CAD. We included studies assessing therapy in human subjects with angina and coronary flow reserve or myocardial perfusion reserve <2.5 by positron emission tomography, cardiac magnetic resonance imaging, dilution methods, or intracoronary Doppler in the absence of coronary artery stenosis ≥50% or structural heart disease. Only 8 papers met the strict inclusion criteria. The papers were heterogeneous, using different treatments, endpoints, and definitions of CMD. The small sample sizes severely limit the power of these studies, with an average of 11 patients per analysis. Studies evaluating sildenafil, quinapril, estrogen, and transcutaneous electrical nerve stimulation application demonstrated benefits in their respective endpoints. No benefit was found with L-arginine, doxazosin, pravastatin, and diltiazem. Our systematic review highlights that there is little data to support therapies for CMD. We assess the data meeting rigorous inclusion criteria and review the related but excluded published data. We additionally describe the next steps needed to address this research gap, including a standardized definition of CMD, routine assessment of CMD in studies of chest pain without obstructive CAD, and specific therapy assessment in the population with confirmed CMD.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.