TY - JOUR
T1 - Safety, Feasibility, and Diagnostic Yield of Invasive Coronary Function TestingNetherlands Registry of Invasive Coronary Vasomotor Function Testing
AU - Crooijmans, Caia
AU - Jansen, Tijn P. J.
AU - Meeder, Joan G.
AU - Woudstra, Janneke
AU - Meuwissen, Martijn
AU - De Vos, Annemiek M. J.
AU - Paradies, Valeria
AU - Bijvank, Els G. M. Olde
AU - Winkler, Patty
AU - Vos, Nicola S.
AU - Arkenbout, Karin
AU - Woudstra, Pier
AU - Stoel, Martin G.
AU - van de Hoef, Tim P.
AU - van den Oord, Stijn C. H.
AU - Widdershoven, Jos W. M. G.
AU - Remkes, Wouter
AU - Cetinyurek-Yavuz, Aysun
AU - Den Ruijter, Hester M.
AU - Onland-Moret, N. Charlotte
AU - Boersma, Eric
AU - Beijk, Marcel A. M.
AU - Appelman, Yolande
AU - Piek, Jan J.
AU - Konst, Regina E.
AU - Maas, Angela H. E. M.
AU - Van Royen, Niels
AU - Dimitriu-Leen, Aukelien C.
AU - Elias-Smale, Suzette E.
AU - Damman, Peter
AU - NL-CFT Investigators
PY - 2025/4/9
Y1 - 2025/4/9
N2 - Importance Patients with angina and no obstructive coronary artery disease frequently have coronary vasomotor dysfunction as underlying pathophysiological mechanism, comprising epicardial spasm, microvascular spasm, and/or microcirculatory dysfunction. These endotypes can be diagnosed by invasive coronary function testing which has previously shown to be safe in tertiary and expert centers. Objective To determine the prevalence of vasomotor dysfunction in patients with angina and no obstructive coronary artery disease who were clinically referred for a coronary function test (CFT); and assess safety and feasibility of a CFT. Design, Setting, and Participants This quality improvement study was performed using the Netherlands Registry of Invasive Coronary Vasomotor Function Testing (NL-CFT), a prospective, observational registry, in 15 participating hospitals (2 tertiary and 13 nontertiary). Patients with angina and no obstructive coronary artery disease who were referred for a clinically indicated CFT between December 2020 and January 2024 were included. Main Outcomes and Measures A complete CFT consisted of acetylcholine spasm provocation testing and assessment of microcirculatory function. Prevalence of different endotypes based on test results and overall safety were assessed. Results Among a total of 1207 patients included, 978 (81%) were female; and the mean (SD) age was 60 (10) years. The prevalence of coronary vasomotor dysfunction was very high (78%). There were 11 (0.9%) major and 10 (0.8%) minor complications reported. Of them, 3 major and all minor were definitely related to the coronary function test. No procedural death, myocardial infarction, or stroke was observed. No differences were found in the occurrence of complications between tertiary and nontertiary centers. Conclusions and Relevance This study found that a CFT was feasible and safe to perform in both tertiary and nontertiary centers with a high diagnostic yield.
AB - Importance Patients with angina and no obstructive coronary artery disease frequently have coronary vasomotor dysfunction as underlying pathophysiological mechanism, comprising epicardial spasm, microvascular spasm, and/or microcirculatory dysfunction. These endotypes can be diagnosed by invasive coronary function testing which has previously shown to be safe in tertiary and expert centers. Objective To determine the prevalence of vasomotor dysfunction in patients with angina and no obstructive coronary artery disease who were clinically referred for a coronary function test (CFT); and assess safety and feasibility of a CFT. Design, Setting, and Participants This quality improvement study was performed using the Netherlands Registry of Invasive Coronary Vasomotor Function Testing (NL-CFT), a prospective, observational registry, in 15 participating hospitals (2 tertiary and 13 nontertiary). Patients with angina and no obstructive coronary artery disease who were referred for a clinically indicated CFT between December 2020 and January 2024 were included. Main Outcomes and Measures A complete CFT consisted of acetylcholine spasm provocation testing and assessment of microcirculatory function. Prevalence of different endotypes based on test results and overall safety were assessed. Results Among a total of 1207 patients included, 978 (81%) were female; and the mean (SD) age was 60 (10) years. The prevalence of coronary vasomotor dysfunction was very high (78%). There were 11 (0.9%) major and 10 (0.8%) minor complications reported. Of them, 3 major and all minor were definitely related to the coronary function test. No procedural death, myocardial infarction, or stroke was observed. No differences were found in the occurrence of complications between tertiary and nontertiary centers. Conclusions and Relevance This study found that a CFT was feasible and safe to perform in both tertiary and nontertiary centers with a high diagnostic yield.
KW - INTERNATIONAL STANDARDIZATION
KW - ARTERY-DISEASE
KW - CRITERIA
KW - ANGINA
U2 - 10.1001/jamacardio.2024.5670
DO - 10.1001/jamacardio.2024.5670
M3 - Article
SN - 2380-6583
VL - 10
SP - 384
EP - 390
JO - JAMA Cardiology
JF - JAMA Cardiology
IS - 4
ER -