Abstract 4371150: Psychological Distress and Impaired Physical Function in Women Diagnosed with Coronary Microvascular Dysfunction

Introduction: Women with chest pain but no obstructive coronary artery disease (oCAD) may have coronary microvascular dysfunction (CMD), which is linked to ischemia, increased cardiovascular risk, and reduced quality of life (QoL). Psychological factors such as anxiety, depression, and stress may further impair functioning in both obstructive and non-obstructive groups, but their role in women with CMD remains understudied. We evaluated psychosocial and health-related QoL in postmenopausal women with CMD, oCAD, and healthy controls. Methods: Postmenopausal women with chest pain (n=50) were enrolled in two separate groups: oCAD (n=13; >50% stenosis), CMD (n=14; non-obstructive CAD with coronary flow reserve <2.5 or index of microcirculatory resistance >25), and a third group was included as healthy controls (n=23; no cardiac history, medications, or abnormal stress tests). Participants completed baseline assessments of demographics, cardiovascular risk factors, and validated psychosocial and QoL measures. Depression was assessed using the Beck Depression Inventory (BDI; 0–63), anxiety using the State-Trait Anxiety Inventory (STAI; 20–80), perceived stress using the Perceived Stress Scale (PSS-14; 0–56), and PTSD symptoms using the PCL-5 (0–80). Higher scores reflected greater symptom severity. Health-related QoL was measured across eight domains with the Short Form-36 (SF-36; 0–100); higher scores indicated better functioning. ANOVA and chi square analysis were done to compare variables across 3 groups. Linear regression model was applied to assess the difference among groups using control as a reference. Results: The mean age was 62 ± 10 years. Baseline characteristics were comparable across groups. CMD patients showed more depressive symptoms, PTSD symptoms, and perceived stress ( p ≤ 0.04) and worse SF-36 scores compared to controls in physical functioning, role limitations–physical, energy/fatigue, social functioning, pain, and general health ( all p ≤ 0.01) depicting marked impairments whereas oCAD did not differ from controls-highlighting the distinct functional and psychological burden of CMD. Conclusions: Women with CMD experience greater impairments in physical and psychosocial functioning than both healthy controls and oCAD. These findings underscore the overlooked burden of CMD and the need for targeted interventions addressing quality of life and mental health in this at-risk population.