Impact of Confirmatory Invasive Coronary Function Testing on Seattle Angina Questionnaire-7 Scores in Patients with Angina and Nonobstructive Coronary Arteries.

The Seattle Angina Questionnaire-7 (SAQ-7) is a tool that is frequently used to quantify symptoms and guide management in patients with angina. Management of angina with nonobstructive coronary artery disease (ANOCA) is directed at the type of pathology identified during invasive coronary function testing (CFT), which includes vasospastic disease, endothelial dysfunction, and coronary microvascular dysfunction (CMD). We studied the impact of confirmatory invasive CFT on SAQ-7 scores. We analyzed a retrospective cohort of 175 patients with suspected ANOCA of which 39% were men and 61% were women. We then evaluated SAQ-7 scores among participants with positive CFT. A two-sided t-test was used to compare the mean pre-test and mean post-test SAQ-7 scores across the three different domains. Among 163 completed coronary function tests, ANOCA was confirmed in 60.7% of cases. Among positive cases, 43.4% were men and 56.6% were women (p > 0.05). Mean score for pre-procedural SAQ-7 of 43.2 (SD ± 22.6, 95% CI [37.7, 48.7]) differed significantly from post-procedural SAQ-7 of 58.1 (SD ± 29.4, 95% CI [50.1, 66.2], p <0.05). SAQ-7 scores were also analyzed by individual domain (functional capacity, frequency of symptoms, and quality of life). The baseline mean functional capacity score was 36.8 (SD ± 26.5) compared to a post-procedural mean score of 51.2 (SD ± 32.5) with p < 0.01. For the frequency of symptoms domain, baseline mean score was 59.0 (SD ± 25.4) compared to a post-procedural mean score of 70.2 (SD ± 29.7) with p < 0.01. Finally, the baseline mean quality of life score was 28.5 (SD ± 28.5) compared to a post-procedural mean score of 50.4 (SD ± 41.2) with p < 0.01. Our data is clear that total SAQ-7 scores improved from baseline in patients confirmed to have ANOCA by CFT. Moreover, this improvement was observed across all three domains of the SAQ-7 questionnaire: functional capacity, frequency of symptoms, and quality of life. This finding validates the SAQ-7 questionnaire as a useful tool in patients with ANOCA for objective assessment of symptom burden and monitoring of clinical progress to guide further management.