What Are the Clinical Implications?
limiting angina, Angina, angina, nonobstructive coronary arteries, ANOCA, Coronary Microvascular Angina
CORONARY MICROVASCULAR DISEASE
CFR measurement should be considered in patients with limiting angina and nonobstructive coronary arteries to identify those who will derive benefit from anti-ischemic therapy.Patients with an abnormal CFR responded to therapy, whereas those with a normal CFR did not, suggesting that physiology-stratified therapy may be preferable to treating undifferentiated patients with angina and nonobstructive coronary arteries with empirical therapy.Among patients with an impaired CFR, measurement of minimal microvascular resistance may enable tailored, pathobiology-directed, therapy.Angina with nonobstructive coronary arteries (ANOCA) is a common clinical condition,Although the CorMicA study (Coronary Microvascular Angina) has previously demonstrated the value of coronary physiology-stratified therapy in enhancing angina-specific quality of lifeThe ChaMP-CMD trial (Characterising Mechanisms in Patients with Coronary Microvascular Disease to Stratify Therapy) aims to assess whether a diminished CFR relates to the effects of anti-ischemic therapy on exercise time in patients with ANOCA and, if it does, whether further endotyping, on the basis of minimal microvascular resistance, allows even more granular stratification of therapy.