Milestone Set for Diagnosis and Prognosis of Coronary Microvascular Dysfunction

Samsung Medical Center Joint Research Team Analyzes 1,003 Patients
Higher Prevalence of Microvascular Dysfunction in Patients with Stenosis
Study Results Published in the International Journal "The Lancet"

A domestic collaborative research study has been published that prospectively analyzed the prevalence and prognosis of coronary microvascular dysfunction (CMD).

A research team that prospectively analyzed the prevalence and prognosis of coronary microvascular dysfunction. Samsung Medical Center

Samsung Medical Center announced on May 26 that a research team led by Professor Lee Jumyung of the Division of Cardiology and Professor Lee Seungheon of Chonnam National University Hospital has published the results of a study analyzing the prevalence and prognosis of coronary microvascular dysfunction in patients undergoing coronary angiography in the international journal The Lancet.

This study was conducted based on the 'FLOW-CMD Registry,' which included participation from seven medical institutions in Korea from April 2022 to November 2024. The study targeted 1,003 patients who underwent coronary angiography with physiological assessment due to suspected ischemic heart disease. The average age was 65 years, and 75.4% of the participants were male.

The results showed that coronary microvascular dysfunction was identified in 163 patients among the total study group. Among the 573 patients with coronary artery stenosis, 123 (21.5%) were found to have microvascular dysfunction, while in the group without stenosis, 40 out of 430 patients (9.3%) were affected.

The median follow-up period was 1.9 years. During this time, major outcome events—including death, myocardial infarction, repeat revascularization, and hospitalization for heart failure—occurred in 26 patients within the microvascular dysfunction group. According to Kaplan-Meier analysis, the estimated two-year incidence rate was 18.8%. In contrast, the incidence in the group without microvascular dysfunction was 10.5%, showing a statistically significant difference. Notably, the risk of major cardiovascular events was 1.91 times higher in patients with microvascular dysfunction compared to those without.

Professor Lee Jumyung stated, "Current guidelines mainly recommend microvascular function assessment for patients without coronary artery stenosis. However, our study found a higher prevalence and greater associated risk of microvascular dysfunction in patients with stenosis, highlighting the need to expand physiological assessments to this group as well." This study was also selected as a 'Late-Breaking Clinical Trial' and presented at EuroPCR 2026, the annual congress of the European Association of Percutaneous Cardiovascular Interventions, held recently in Paris, France.

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