Clinical characteristics and biomarkers of coronary microvascular dysfunction and obstructive coronary artery disease

Abstract

Objective: The purpose of this study was to determine the clinical characteristics and biomarkers in patients with coronary microvascular dysfunction (CMVD) and to compare them with patients with obstructive coronary artery disease (OCAD). Methods: We conducted a single-center, hospital-based, observational, descriptive, comparative, clinical study of 40 patients, including 20 patients with CMVD and 20 with OCAD. We assessed laboratory biomarkers (low-density lipoprotein [LDL], high-density lipoprotein [HDL], red blood cell distribution width [RDW], brain natriuretic protein [BNP], troponin I), and PET/CT coronary flow reserve was performed. Results: The mean coronary flow reserve (CFR) in patients with CMVD was 1.96±0.55. Mean low-density lipoprotein cholesterol (LDL-C) levels were significantly higher in the CMVD subgroup (2.53±0.63 mmol/L) compared with the OCAD subgroup (1.76±0.97 mmol/L). Logistic regression analysis identified LDL-C as a predictor for the development of CMVD (odds ratio, 5.24). Conclusion: It is difficult to differentiate between OCAD and CMVD based on the patient’s medical history, clinical characteristics, and coronary angiography results. Further investigations may be needed to allow an accurate diagnosis. CFR measurements based on non-invasive positron emission tomography/computed tomography may aid the diagnosis of CMVD. We also identified LDL-C as a predictor for the development of CMVD.