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5.2.3. Patients With Ischemia and No Obstructive CAD
(INOCA)
COR LOE
Recommendations
2a B-NR 1. For patients with persistent stable chest pain and
nonobstructive CAD and at least mild myocardial ischemia
on imaging, it is reasonable to consider invasive coronary
function testing to improve the diagnosis of coronary
microvascular dysfunction and to enhance risk stratification.
2a B-NR 2. For patients with persistent stable chest pain and
nonobstructive CAD, stress PET MPI with MBFR is
reasonable to diagnose microvascular dysfunction and
enhance risk stratification.
2a B-NR 3. For patients with persistent stable chest pain and
nonobstructive CAD, stress CMR with the addition of
MBFR measurement is reasonable to improve diagnosis of
coronary myocardial dysfunction and for estimating risk of
MACE.
2b C-EO 4. For patients with persistent stable chest pain and
nonobstructive CAD, stress echocardiography with the
addition of coronary flow velocity reserve measurement may
be reasonable to improve diagnosis of coronary myocardial
dysfunction and for estimating risk of MACE.
