Lots of interesting abstracts and cases were submitted for TCTAP 2025. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-034

Incidence of Coronary Microvascular Dysfunction in Anoca Patients With and Without a History of Severe COVID-19 Infection: The COMET-19 Study

By Tsungying Tsai, Ali Aldujeli, Ayman Haq, Aurimas Knokneris, Kasparas Briedis, Diarmaid Hughes, Ramunas Unikas, Mick Renkens, Pruthvi Revaiah, Kotaro Miyashita, Akihiro Tobe, Asahi Oshima, Faisal Sharif, Scot Garg, Yoshinobu Onuma, Patrick Serruys

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Presenter

TsungYing Tsai

Authors

Tsungying Tsai¹, Ali Aldujeli², Ayman Haq³, Aurimas Knokneris², Kasparas Briedis², Diarmaid Hughes⁴, Ramunas Unikas², Mick Renkens⁵, Pruthvi Revaiah¹, Kotaro Miyashita¹, Akihiro Tobe¹, Asahi Oshima¹, Faisal Sharif⁶, Scot Garg⁷, Yoshinobu Onuma¹, Patrick Serruys¹

Affiliation

University of Galway, Ireland¹, Lithuanian University of Health Sciences, Lithuania², Abbott Northwestern Hospital, USA³, Sligo University Hospital, Ireland⁴, Amsterdam University Medical Center, Netherlands⁵, University Hospital Galway, Ireland⁶, Royal Blackburn Hospital, United Kingdom⁷

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TCTAP A-034

Small Vessel Disease

Incidence of Coronary Microvascular Dysfunction in Anoca Patients With and Without a History of Severe COVID-19 Infection: The COMET-19 Study

Background

Post-acute sequelae of SARS-CoV-2 infection can manifest as anginal chest pain. However, the underlying mechanisms, including the role of coronary microvascular dysfunction (CMD), remain elusive. We investigated the CMD incidence and endotypes in angina without obstructive coronary artery disease (ANOCA) patients with a history of severe COVID-19 infection.

Methods

COMET-19(NCT05841485) is a multicentre, prospective cross-sectional study including 117 consecutive ANOCA patients: 59 with a history of severe COVID-19 infection (COVID group) and 58 without (Control group). All patients underwent coronary physiology assessment for fractional flow reserve (FFR), coronary flow reserve (CFR), and index of microvascular resistance (IMR). CMD was defined as CFR<2.0 or IMR≥25, with functional CMD defined as CFR<2.0 and IMR<25, and structural CMD defined as CFR<2.0 and IMR≥25.

Results

The incidence of CMD was 47.5 %(n=28) in the COVID group and 24.1%(n=14) in the Control group (p=0.015), predominantly driven by the higher incidence of structural CMD in the COVID group (28.8% vs. 5.8%, p<0.001), while functional CMD was more common in the Control group (19.0% vs. 6.8%, p<0.001).(FigA,B) Compared to the Control, COVID patients had significantly higher IMR (20.0 [15.0, 42.0] vs. 17.0 [12.0, 21.0], p=0.002) but similar FFR (0.89 vs. 0.9, p=0.327) and CFR (2.68 vs. 2.74, p=0.540).

Conclusion

ANOCA patients with a history of severe COVID-19 infection had a higher incidence of CMD, particularly structural CMD, suggesting the link between COVID-19 and microvascular impairment.

E-Abstract

TCTAP A-034