Clinical outcomes of angina treatment in coronary microvascular dysfunction: results of a multicenter observational study
Abstract
BackgroundCoronary microvascular dysfunction (CMD or CMVD), a major subtype of angina with non-obstructive coronary arteries, affects a substantial proportion of patients and represents an important unmet clinical need, particularly in China. Studies evaluating comparative treatment efficacy in angina populations, especially across CMVD and non-CMVD, remain limited.ObjectiveTo assess the efficacy of different therapeutic regimens (nicorandil vs. non-nicorandil treatment) among angina pectoris patients with CMVD.MethodsWe conducted a retrospective analysis of baseline and follow-up data from nine centres of the GREAT study, including patients with angina from nine hospitals in China treated with nicorandil or non-nicorandil regimens. Patients with and without CMVD (coronary angiography-derived index of microvascular resistance [caIMR], ≥25 vs. < 25) were included, and post-treatment differences in Seattle Angina Questionnaire (SAQ) scores were compared between groups.ResultsA total of 1,259 patients with angina were included in this study. Among them, 429 patients had CMVD (caIMR ≥25), comprising 170 in the nicorandil group and 259 in the non-nicorandil group, while 830 patients did not have CMVD (nicorandil group, 319; non-nicorandil group, 511). After propensity score matching, the mean SAQ summary score (SAQ-SS) improvement in patients with CMVD, was greater in the nicorandil group than in the non-nicorandil group (mean change: 16.80 vs. 12.60, P = 0.044). Among patients without CMVD, nicorandil therapy resulted in significantly greater SAQ-SS improvement at respective timepoints (3 months: 15.68 vs. 12.15, P = 0.005; 6 months: 18.70 vs. 14.44, P < 0.001; 9 months: 18.11 vs. 15.07, P = 0.008).ConclusionNicorandil-based regimens may be associated with greater improvement in health status among angina patients with CMVD compared with non-nicorandil treatments.
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BibTeX
@article{zhang2026clinical,
title = {{Clinical outcomes of angina treatment in coronary microvascular dysfunction: results of a multicenter observational study}},
author = {Yang Zhang and Su’e Xu and Litao Wu and Yajuan Liu and Xin Du and Guojie Cheng and Liling Sun and Ying Wei and Wei Liu and Lifu Miao and Qihua Zhang and Changsheng Ma and Yong Zeng},
journal = {Frontiers in Pharmacology},
year = {2026},
month = nov,
doi = {10.3389/fphar.2026.1938738},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1938738},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Clinical outcomes of angina treatment in coronary microvascular dysfunction: results of a multicenter observational study
AU - Yang Zhang
AU - Su’e Xu
AU - Litao Wu
AU - Yajuan Liu
AU - Xin Du
AU - Guojie Cheng
AU - Liling Sun
AU - Ying Wei
AU - Wei Liu
AU - Lifu Miao
AU - Qihua Zhang
AU - Changsheng Ma
AU - Yong Zeng
PY - 2026
DA - 2026/11/02
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.1938738
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.1938738
AB - BackgroundCoronary microvascular dysfunction (CMD or CMVD), a major subtype of angina with non-obstructive coronary arteries, affects a substantial proportion of patients and represents an important unmet clinical need, particularly in China. Studies evaluating comparative treatment efficacy in angina populations, especially across CMVD and non-CMVD, remain limited.ObjectiveTo assess the efficacy of different therapeutic regimens (nicorandil vs. non-nicorandil treatment) among angina pectoris patients with CMVD.MethodsWe conducted a retrospective analysis of baseline and follow-up data from nine centres of the GREAT study, including patients with angina from nine hospitals in China treated with nicorandil or non-nicorandil regimens. Patients with and without CMVD (coronary angiography-derived index of microvascular resistance [caIMR], ≥25 vs. < 25) were included, and post-treatment differences in Seattle Angina Questionnaire (SAQ) scores were compared between groups.ResultsA total of 1,259 patients with angina were included in this study. Among them, 429 patients had CMVD (caIMR ≥25), comprising 170 in the nicorandil group and 259 in the non-nicorandil group, while 830 patients did not have CMVD (nicorandil group, 319; non-nicorandil group, 511). After propensity score matching, the mean SAQ summary score (SAQ-SS) improvement in patients with CMVD, was greater in the nicorandil group than in the non-nicorandil group (mean change: 16.80 vs. 12.60, P = 0.044). Among patients without CMVD, nicorandil therapy resulted in significantly greater SAQ-SS improvement at respective timepoints (3 months: 15.68 vs. 12.15, P = 0.005; 6 months: 18.70 vs. 14.44, P < 0.001; 9 months: 18.11 vs. 15.07, P = 0.008).ConclusionNicorandil-based regimens may be associated with greater improvement in health status among angina patients with CMVD compared with non-nicorandil treatments.
SN - 1663-9812
ER -