Evidence map›Paper›PMID 38749588›Full record

ArticleJACC. Cardiovascular interventions2024

Multivessel Coronary Function Testing Increases Diagnostic Yield in Patients With Angina and Nonobstructive Coronary Arteries.

Rajan Rehan, Christopher C Y Wong, James Weaver, William Chan, Jennifer A Tremmel, William F Fearon, Martin K C Ng, Andy S C Yong

Abstract readMulticenter StudyComparative Study
PubMed Publisher
In one paragraph

Article in JACC. Cardiovascular interventions, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed.

  1. Trial
  2. Coronary microvascular dysfunction: a narrative review.Cardiovascular diagnosis and therapy · 2026
    Review
  3. Article
  4. Article
  5. Coronary microvascular disease in patients referred to coronary angiography following coronary computed tomography angiography.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025
    Observational
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Rajan RehanRoyal Prince Alfred Hospital, Sydney, Australia.
Christopher C Y WongStanford University Medical Center, Stanford, California, USA.
James WeaverRoyal Prince Alfred Hospital, Sydney, Australia.
William ChanRoyal Prince Alfred Hospital, Sydney, Australia.
Jennifer A TremmelStanford University Medical Center, Stanford, California, USA.
William F FearonRoyal Prince Alfred Hospital, Sydney, Australia.
Martin K C NgRoyal Prince Alfred Hospital, Sydney, Australia.
Andy S C YongConcord Hospital, Concord, Australia. Electronic address: andy.yong@sydney.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInvasive CFT is the gold standard for diagnosing coronary vasomotor dysfunction in patients with ANOCA. Most institutions recommend only testing the left coronary circulation. Therefore, it is unknown whether testing multiple coronary territories would increase diagnostic yield.

objectivesThe aim of this study was to evaluate the diagnostic yield of multivessel, compared with single-vessel, invasive coronary function testing (CFT) in patients with angina and nonobstructive coronary arteries (ANOCA).

methodsMultivessel CFT was systematically performed in patients with suspected ANOCA. Vasoreactivity testing was performed using acetylcholine provocation in the left (20 to 200 μg) and right (20 to 80μg) coronary arteries. A pressure-temperature sensor guidewire was used for coronary physiology assessment in all three epicardial vessels.

resultsThis multicenter study included a total of 228 vessels from 80 patients (57.8 ± 11.8 years of age, 60% women). Compared with single-vessel CFT, multivessel testing resulted in more patients diagnosed with coronary vasomotor dysfunction (86.3% vs 68.8%; P = 0.0005), coronary artery spasm (60.0% vs 47.5%; P = 0.004), and CMD (62.5% vs 36.3%; P < 0.001). Coronary artery spasm (n = 48) predominated in the left coronary system (n = 38), though isolated right coronary spasm was noted in 20.8% (n = 10). Coronary microvascular dysfunction (CMD), defined by abnormal index of microcirculatory resistance and/or coronary flow reserve, was present 62.5% of the cohort (n = 50). Among the cohort with CMD, 27 patients (33.8%) had 1-vessel CMD, 15 patients (18.8%) had 2-vessel CMD, and 8 patients (10%) had 3-vessel CMD. CMD was observed at a similar rate in the territories supplied by all 3 major coronary vessels (left anterior descending coronary artery = 36.3%, left circumflex coronary artery = 33.8%, right coronary artery = 31.3%; P = 0.486).

conclusionsMultivessel CFT resulted in an increased diagnostic yield in patients with ANOCA compared with single-vessel testing. The results of this study suggest that multivessel CFT has a role in the management of patients with ANOCA.

Indexed as

AcetylcholineAngina PectorisCoronary Artery DiseaseCoronary CirculationCoronary VasospasmCoronary VesselsPredictive Value of TestsVasodilator AgentsAgedCardiac CatheterizationCoronary AngiographyFemaleHumansMaleMiddle AgedReproducibility of ResultsAcetylcholineVasodilator AgentsANOCAcoronary artery spasmcoronary microvascular dysfunctioncoronary vasomotor dysfunctionmultivessel coronary function testing

Identifiers

PMID38749588

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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 Socratic graph.