COVADIS’ study on MVA primarily compared patterns of abnormal coronary vasomotion between Caucasian and Japanese populations primarily, and reported ethnic differences in clinical presentations. However, these may be explained by MVA’s pathophysiological mechanisms’ differing prevalence from population to population.
The relationship between gender and quality of life of patients with MVA also remains unclear: COVADIS highlighted a higher prevalence of MVA in women than in men, yet the former reported significantly reduced quality of life. Take-home message: Further research on MVA’s prevalence in a wider range of ethnicities is essential, particularly in regions with increased prevalence of risk factors associated with MVA. This research should document the prevalence of microvascular spasm as well the different endotypes of coronary microvascular dysfunction.
Gaps in the identification of factors accounting for possible gender-related differences in quality of life should also be addressed. Breaching them is pivotal in the diagnosis, treatment and management of MVA.