Invasive functional testing in the cath lab as a routine investigation in INOCA: pros and cons

Introduction While invasive coronary angiography can evaluate epicardial coronary arteries in patients with suspected ischaemia, it may not be sufficient for those with ischaemia and non-obstructed coronary arteries (INOCA). In these cases, a more accurate diagnostic approach involving invasive functional testing can be considered. However, the routine use of invasive functional testing in INOCA patients is still an area of debate due to uncertainties surrounding its diagnostic value, optimal thresholds, cost-effectiveness, and therapeutic implications.

Pros Bernard De Bruyne, MD, PhD; Marta Belmonte, MD

The goal of invasive coronary angiography is to identify the cause of a patient&...