Observational studyJournal of the American Heart Association2026
Comprehensive Endotyping of Patients With Angina and Nonobstructive Coronary Arteries: A Report From the J-CMD.
Observational study in Journal of the American Heart Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- Intravascular imaging in myocardial infarction and ischemia with nonobstructive coronary arteries.Cardiovascular intervention and therapeutics · 2026Review
Corrections and comments
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Authors and funding
19 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAngina with nonobstructive coronary arteries (ANOCA) is frequently driven by coronary vasospasm and coronary microvascular dysfunction (CMD). Despite recommendations for comprehensive invasive testing to phenotype ANOCA, prospective data on the prevalence and interplay of these endotypes remain limited. We aimed to investigate the prevalence, clinical correlations, and overlap of epicardial vasospasm, microvascular spasm, and CMD, defined by a coronary flow reserve <2.0.
methodsWe analyzed the data from a prospective, multicenter nationwide registry of the J-CMD (Japanese Association of Coronary Microvascular Dysfunction; UMIN000047609). Patients with ANOCA underwent standardized intracoronary functional testing, including acetylcholine-based spasm provocation and coronary flow reserve assessment. The distribution of the endotypes (epicardial vasospasm, microvascular spasm, isolated CMD, and CMD with spasm) was investigated according to sex and age tertiles.
resultsOf 947 patients (55.6% women), epicardial vasospasm was the most common diagnosis (44.2%), followed by microvascular spasm (16.5%), CMD with spasm (8.7%), and isolated CMD (5.0%). Substantial overlap was evident; concurrent CMD and any vasospasm were more frequent in women than in men (10.8% versus 6.0%,
conclusionsAmong patients with ANOCA, coronary vasospasm and CMD were prevalent and frequently coexisted, demonstrating distinct sex- and age-related patterns. These findings offer novel insights into the heterogeneous pathophysiology of ANOCA and reinforce the importance of comprehensive invasive assessment in establishing a precise diagnosis and guiding targeted therapy.
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