TABLE 1

Invasive coronary function testing in patients with INOCA: Three medications

Drug administeredResultsDiagnosis
1. AdenosineCoronary flow reserve < 2.5Nonendothelial-dependent microvascular dysfunction
2. Acetylcholine< 50% increase in coronary blood flowEndothelial-dependent microvascular dysfunction
< 5% increase in coronary artery diameterEndothelial-dependent macrovascular dysfunction
> 90% decrease in coronary artery diameter
Chest pain and ischemic ST-segment changes on electrocardiography
Epicardial coronary spasm
Chest pain and ischemic ST-segment changes on electrocardiography in the absence of significant epicardial coronary vasoconstrictionMicrovascular coronary spasm
3. Nitroglycerin< 20% increase in coronary artery diameterNonendothelial-dependent macrovascular dysfunction
  • INOCA = ischemia and no obstructive coronary artery disease (ie, < 50% stenosis)