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Updated: Jul 18, 2026
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Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders
Published on: February 3, 2021
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Safety, Feasibility, and Diagnostic Yield of Invasive Coronary Function Testing: Netherlands Registry of Invasive
Caïa Crooijmans1, Tijn P J Jansen1, Joan G Meeder2
1Department of Cardiology Radboudumc, Nijmegen, the Netherlands.
JAMA Cardiology
|February 19, 2025
Summary
Coronary vasomotor dysfunction is common in angina patients without obstructive coronary artery disease. Coronary function testing (CFT) is a safe and feasible diagnostic tool for identifying this condition across various hospital settings.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Testing
Background:
- Coronary vasomotor dysfunction (CVD) is a frequent cause of angina in patients with non-obstructive coronary artery disease.
- Diagnosing CVD typically involves invasive coronary function testing (CFT), which has been considered safe in expert centers.
Purpose of the Study:
- To determine the prevalence of CVD in patients with angina and no obstructive coronary artery disease referred for CFT.
- To assess the safety and feasibility of performing CFT in a multicenter setting.
Main Methods:
- A prospective, observational registry (NL-CFT) collected data from 15 hospitals (2 tertiary, 13 nontertiary).
- Patients with angina and no obstructive coronary artery disease undergoing clinically indicated CFT between December 2020 and January 2024 were included.
- CFT involved acetylcholine spasm provocation and microcirculatory function assessment.
Main Results:
- A total of 1207 patients were included; 81% were female, mean age 60 years.
- The prevalence of coronary vasomotor dysfunction was high at 78%.
- The overall complication rate was low (0.9% major, 0.8% minor), with no deaths, myocardial infarctions, or strokes. Complication rates were similar between tertiary and nontertiary centers.
Conclusions:
- Coronary function testing is a feasible and safe procedure in both tertiary and nontertiary centers.
- CFT demonstrates a high diagnostic yield for identifying coronary vasomotor dysfunction in patients with angina and non-obstructive coronary artery disease.
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