Protein biomarkers and coronary microvascular dilatation assessed by rubidium-82 PET in women with angina pectoris and no obstructive coronary artery disease

Abstract Background and aims While a plethora of biomarkers have been shown to be associated with coronary artery disease, studies assessing biomarkers in coronary microvascular dysfunction (CMD) are few. We investigated associations between cardiovascular protein biomarkers and non-endothelium dependent CMD assessed by positron emission tomography (PET). Methods In 97 women with angina pectoris and no significant obstructive coronary artery disease ( Results Median age was 62 years (range 31–79), median MBFR was 2.7 (range 1.2–4.7) and 32% had non-endothelium dependent CMD (MBFR p  = 0.008), growth differentiation factor 15 (GDF15, p  = 0.026), tissue-type plasminogen activator (tPA, p  = 0.030) and von Willebrand factor (vWF, p  = 0.018), while 12 biomarkers showed a trend for correlation (0.05 ≤  p Conclusions In a panel of 92 cardiovascular protein biomarkers, 4 were significantly associated with non-endothelium dependent CMD in women: Gal4, GDF15, tPA and vWF, suggesting that inflammatory status and coagulation changes are associated with impaired microvascular dilatation. Further confirmatory studies are needed to corroborate these findings.