Coronary microvascular dysfunction (CMD) was an important independent component of ischemic heart disease, though it often accompanied epicardial coronary artery disease, a prospective study showed.
In a large, unselected population undergoing clinically indicated invasive coronary angiography (ICA) in routine practice for suspected ischemic heart disease, microvascular dysfunction was associated with higher 2-year estimated risk of the composite endpoint of all-cause death, myocardial infarction, clinically-driven repeat revascularization, or hospitalization for heart failure (18.8% vs 10.5% without CMD, HR 1.91, 95% CI 1.22-2.99).
While particularly common among patients with obstructive epicardial coronary artery disease (21.5% vs 9.3% without obstructive disease), CMD carried an even more elevated outcome risk in people without obstructive epicardial coronary disease (31.4% vs 9.0%, HR 3.45, 95% CI 1.69-7.06), reported Joo Myung Lee, MD, MPH, PhD, of Samsung Medical Center in Seoul, at the EuroPCR meeting in Paris.
Lee's FLOW-CMD registry study, which included seven Korean sites and over 1,000 participants, was simultaneously published in The Lancet.
The report also noted that patients with CMD tended toward worse angina profiles after percutaneous coronary intervention (PCI) than their non-CMD peers, although without reaching statistical significance.
