Metoprolol vs. Diltiazem in Patients with Angina and Non-Obstructive Coronary Artery Disease with or Without Evidence of Coronary Microvascular Spasm on Acetylcholine Testing.

ABSTRACT: Background: Pharmacologic therapy guided by invasive coronary function tests (CFTs) may improve symptomatic outcomes in patients with angina and non-obstructive coronary artery disease (ANOCA). In this study, we specifically aimed to investigate whether the induction of coronary microvascular spasm (CMVS) by the acetylcholine (Ach) test predicts a better therapeutic effect of calcium-channel blocker therapy compared to beta-blocker therapy. Methods: We enrolled 31 ANOCA patients, who were divided into two groups according to the result of Ach testing: 16 patients with CMVS (CMVS group) and 15 patients with a negative test (NEG group). Patients with Ach-induced epicardial spasm were excluded. In an open-label crossover trial, patients were randomly assigned to each receive, fo

SUBMITTER: Marino AG 

PROVIDER: S-EPMC12608405 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature