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Updated: Sep 11, 2025

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

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Coronary function testing vs angiography alone to guide treatment of angina with non-obstructive coronary arteries:

Coen K M Boerhout1, Hanae F Namba1, Tommy Liu2,3,4

  • 1Department of Cardiology, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands.

European Heart Journal
|August 12, 2025
PubMed

Insights

Routine invasive coronary function testing (CFT) in angina with non-obstructive coronary arteries (ANOCA) is safe and effective. Combining CFT with tailored treatment significantly improves quality of life for ANOCA patients.

Area of Science:

  • Cardiology
  • Diagnostic Testing
  • Clinical Trials

Background:

  • Coronary vasomotor disorders are common in patients with angina and non-obstructive coronary arteries (ANOCA).
  • Coronary function testing (CFT) has a high diagnostic yield for these disorders.
  • The ILIAS ANOCA trial investigated the routine use of ad hoc CFT.

Purpose of the Study:

  • To assess the feasibility, safety, and effectiveness of routine ad hoc CFT in ANOCA patients.
  • To evaluate if combining CFT with a disease-specific treatment protocol improves quality of life compared to standard care.

Main Methods:

  • Patients with ANOCA undergoing invasive coronary angiography (ICA) were randomized.
  • The intervention group received disclosed CFT results and tailored therapy; the control group received standard care with blinded CFT results.
  • The primary outcome was the change in Seattle Angina Questionnaire summary score (SAQSS) at 6 months.

Main Results:

  • 153 ANOCA patients were randomized; 78% had a diagnosed vasomotor disorder.
  • No adverse events occurred during CFT.
  • The intervention group showed a significant improvement in SAQSS (9.4 units) compared to the control group (P = .001).

Conclusions:

  • Routine ad hoc CFT during initial ICA is feasible, safe, and diagnostically valuable in ANOCA.
  • A pragmatic CFT protocol combined with disease-specific treatment significantly enhances quality of life for ANOCA patients.
Abstract

Keywords:
Angina with non-obstructive coronary arteriesCoronary function testingCoronary microvascular dysfunctionCoronary vasospasm

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