Conference Coverage

WISE sheds light on angina in INOCA



– A higher baseline average coronary peak flow velocity is an independent predictor of angina in women with symptomatic ischemia and nonobstructive coronary artery disease (INOCA), according to a new report from the WISE-CVD study.

Dr. Nissi Sharon Suppogu, Cedars-Sinai Medical Center, Los Angeles Bruce Jancin/MDedge News

Dr. Nissi Sharon Suppogu

WISE-CVD (the Women’s Ischemia Syndrome Evaluation: Coronary Vascular Dysfunction) project is a National Institutes of Health–sponsored series of studies. WISE investigators have previously shown that higher baseline average peak flow velocity (BAPV) is correlated with volumetric flow and is an independent predictor of major adverse cardiovascular events. However, until now the relationship between BAPV and anginal symptoms hadn’t been investigated, Nissi S. Suppogu, MD, observed at the annual meeting of the American College of Cardiology.

She reported on 260 women with angiographically evaluated symptomatic INOCA who participated in WISE-CVD. They were divided into two groups based upon their BAPV: 123 had a BAPV of 22 cm/sec or more, and 137 had a BAPV of less than 22 cm/sec.

Women in the high BAPV group had more frequent angina as shown by their average score of 50 on that domain of the Seattle Angina Questionnaire, compared with 60 in the low-BAPV group. The high-BAPV group also had significantly worse angina-related quality of life as reflected in their lower score on that dimension of a related instrument, the Seattle Angina Questionnaire–7.

Further support for the notion that high-BAPV women with INOCA have more severe angina than those with low BAPV comes from the finding that they were significantly more likely to use nitrates (37.6% of them did so, compared with 22.6% of low-BAPV women) and ranolazine, or Ranexa (7.9% versus 1.7%). In addition, the high-BAPV patients had numerically greater usage of other antianginal agents – beta-blockers, calcium channel blockers, and ACE inhibitors or angiotensin receptor blockers – although these differences didn’t reach statistical significance, reported Dr. Suppogu of Cedars-Sinai Medical Center in Los Angeles.

She reported having no financial conflicts regarding her presentation.

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