ArticleClinical cardiology2023
Effect of nonobstructive coronary stenosis on coronary microvascular dysfunction and long-term outcomes in patients with INOCA.
Article in Clinical cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 14 citations in OpenAlex.
- Review
- Insulin or Dapagliflozin Potentially Improves Microcirculatory Dysfunction or INOCA Related to Culprit Vessels in Diabetic Patients With STEMI After DCB Therapy During Long-Term Follow-Up.Journal of diabetes · 2026Observational
- Effects of SGLT2 inhibitors on angiography-derived coronary microcirculatory resistance and clinical outcomes in patients with coronary heart disease and type 2 diabetes: A cohort study.Diabetology & metabolic syndrome · 2025Article
- Effect of rapamycin-eluting stents on in-stent restenosis and early inflammatory response in coronary artery narrowing animal models.Journal of cardiothoracic surgery · 2025Article
- Article
- Beyond the Obstructive Paradigm: Unveiling the Complex Landscape of Nonobstructive Coronary Artery Disease.Journal of clinical medicine · 2024Review
- Impact of the use of plaque modification techniques on coronary microcirculation using an angiography-derived index of microcirculatory resistance.The international journal of cardiovascular imaging · 2024Article
- Noninvasive transthoracic doppler flow velocity and invasive thermodilution to assess coronary flow reserve.Quantitative imaging in medicine and surgery · 2024Article
- Effect of nonobstructive coronary stenosis on coronary microvascular dysfunction and long-term outcomes in patients with INOCA.Clinical cardiology · 2023Article
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Authors and funding
13 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundIschemic pain with no-obstructive coronary artery (INOCA) is clinically significant and defined by nonobstructive coronary stenosis <50%. Coronary microvascular dysfunction (CMD) is a relevant cause associated with adverse outcomes.
objectivesInvestigated the effect of no-stenosis (0% stenosis) and non-obstructive (0% < stenosis < 50%) on the prognostic impact of CMD in INOCA.
methodA retrospective study assessed the coronary microvascular function in 151 INOCA patients who underwent invasive angiography by the coronary angiography-derived index of microcirculation-resistance (caIMR). CZT-SPECT was performed to evaluate myocardial perfusion imaging (MPI) abnormalities. Chi-square test/Fisher exact test, Student t-test, Kaplan-Meier curve, and Uni-multivariable Cox proportional models were used for analysis. Clinical outcomes were major adverse cardiovascular events (MACE) during a median follow-up of 35 months.
resultNo-stenosis was present in 71 (47%) INOCA patients, and 80 (53%) were with nonobstructive. CMD (caIMR ≥ 25) was more prevalent in patients with no-stenosis than nonobstructive (76.1% vs. 48.8%, p = .001), along with abnormal MPI (39.4% vs. 22.5%, p = .024). The MACE rates were not different between no-stenosis and nonobstructive stenosis. CMD showed an increased risk of MACE for all INOCA. No-stenosis with CMD had the worst prognosis. Cox regression analysis identified CMD and abnormal MPI as predictors of MACE in all INOCA and patients with no-stenosis. However, no-stenosis and nonobstructive stenosis were not predictors of MACE in INOCA.
conclusionCMD was more frequently present in INOCA with no-stenosis. However, there was no difference in long-term clinical outcomes between no-stenosis and nonobstructive stenosis. CMD could independently predict poor outcomes in INOCA, particularly in patients with no-stenosis.
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