Thread by @CardioOBDoc

Sub-study of WISE @JACCJournals by @ahmedalbadrimd @lesleejshaw:

In women with signs & symptoms of ischemia
✅ low CFR (microvascular dysfunction) ➡️ ⬆️ major CV events
✅ endothelial dysfunction ➡️ ⬆️ angina hospitalization
onlinejacc.org/content/73/6/6…
@emorywomenheart @venkmurthy

In this relatively large & very well-done study, 4 indices of coronary dz were invasively measured:

✅ CFR (adenosine): non-endo dependent CMD

✅ CBF (ACh): endo dependent CMD

✅ Nitro Δ CSA: non-endo dependent epicardial dz

✅ ACh Δ CSA: endo depedent epicardial dz

Findings:
1️⃣ low CFR associated with ⬆️ MACE

2️⃣ low CBF not associated with MACE

3️⃣ impaired ACh dilatation assocaited with ⬆️ angina hospitalization

4️⃣ impaired NTG dilatation not associated with MACE
@ahmedalbadrimd @lesleejshaw @gina_lundberg @CedarsSinai @Michel_CorbanMD

Take home message:

✅ Significant portion of 👩🏻👩🏼👩🏽👩🏾👩🏿 with #angina but no obstructive atherosclerotic #coronary dz have signs/symptoms of ischemia & poor CV outcomes

✅ Testing for coronary #microvascular &/or #endothelial dysfunction should be considered in this population