Microvascular vasomotor dysfunction is more prevalent in female versus epicardial vasomotor dysfunction in male ANOCA patients

BACKGROUND: Coronary vasomotor dysfunction, diagnosed by coronary function testing (CFT), has only recently been recognized as important contributor to chronic coronary syndromes, exposing knowledge gaps on sex and age differences. Therefore, these differences are evaluated in the Dutch national CFT registry (NL-CFT). METHODS: Included were 1008 patients (83% women, 60 ± 9.6 years old) with angina and non-obstructive coronary arteries (ANOCA) undergoing CFT between 2020 and 2024. CFT consisted of coronary vasospasm provocation testing and reduced microvascular vasodilatory capacity assessment, a decreased coronary flow reserve (CFR) and/or increased microvascular resistance (MR). Patients were allocated into three age groups based on quartiles: young (≤54 years, Q1), intermediate (>54 to