Study: Coronary Function Testing Improves Diagnosis of Heart Disease in Women

A Yale School of Medicine team finds that women who underwent a common procedure called coronary angiography (CA) were more likely to receive an accurate diagnosis with the use of coronary function testing (CFT), in a recent study published in the Journal of the American Heart Association. Their results suggests that CFT leads to a higher diagnostic yield by deciphering the exact cause of cardiac symptoms, leading to more appropriate adjustments in medical therapy.

The Yale team enrolled 198 women who underwent either CA alone, or CA with CFT. Researchers say 82% of the women undergoing CFT were diagnosed with coronary vasomotor disorders such as coronary microvascular dysfunction (CMD) or coronary vasospasm. In contrast, CA alone often resulted in a diagnosis of nonobstructive coronary artery disease – a critical distinction which influences the subsequent management and treatment strategies that can be deployed to improve patient outcomes.

"More than 1 million heart catheterization procedures are performed in the United States each year, but women are less likely than men to benefit from the procedure," said Samit Shah, MD, Assistant Professor in the Department of Internal Medicine and senior author of the study. "Coronary Function Testing can give women an accurate diagnosis, more intense management of cardiac medications, and a better outcome."

The study also found that medical therapy adjustments post-procedure were more common in the CFT group, with 65% of patients experiencing changes, compared to 41% in the CA alone group. This trend continued at the 30-day follow-up, with 44% of the CFT group having further therapy adjustments versus 30% of the CA alone group.

"Our work showed that in women with ischemic heart disease, CFT can reveal a clear diagnosis in over 80% of women that then leads to targeted changes in cardiac medications." Dr. Shah added.

The study was funded by Women’s Health Research at Yale, an interdisciplinary research center within Yale School of Medicine, to examine sex differences in cardiovascular disease. The Yale team's findings are particularly important for women, who are more likely than men to present with chest pain despite having nonobstructive coronary arteries. The research supports wider adoption of CFT in the diagnostic process for women with symptoms of SIHD.

The study’s first author was Natasha Cigarroa. Other Yale study authors included Nida Latif, Marah Maayah, Arshjot Khokhar, Alexandra Schwann, Kaitlin R. Maciejewski, Natalija Odanovic, Carolyn M. Mazure, Erica Spatz, Steven Pfau, and Alexandra Lansky.