Key result
Patients with chest pain and normal coronary angiograms who exhibited horizontal or down-sloping ST depression on exercise testing had significantly reduced coronary flow reserve compared to those without ST shifting.
Observational (n=93)
No
Absolute Event Rate: 2.1% vs 3.1%
p-value: p=<0.05
Patients with chest pain and normal coronary angiograms exhibit heterogeneous flow abnormalities including reduced coronary flow reserve and slow flow, which may partially improve with angiotensin II receptor blockers.
ST depression on exercise testing may identify reduced CFR in chest pain with normal angiograms; hypothesis-generating for INOCA evaluation and needs prospective validation.
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Youn et al. (2003) conducted an observational in Chest pain with normal coronary angiogram (n=93). Horizontal or down-sloping ST depression on exercise treadmill test vs. No ST shifting or up-sloping ST depression was evaluated on Coronary flow reserve (CFR) (p=<0.05). Patients with chest pain and normal coronary angiograms who exhibited horizontal or down-sloping ST depression on exercise testing had significantly reduced coronary flow reserve compared to those without ST shifting.
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