Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Medical Science (MMSc)

First Advisor

Erica Spatz, MD, MHS


Ischemic heart disease is the leading cause of death for women in the Western hemisphere. Women with ischemic heart disease typically present to the emergency department with acute coronary syndrome, and subsequently undergo coronary angiography. In 66% of women, no evidence of obstructive disease is found, and current standard of care recommends no further diagnostic testing. However, nonobstructive diseases cannot be ruled out with coronary angiography alone and therefore are frequently missed. This study will examine whether invasive physiological testing with coronary angiography can impact multiple adverse cardiac events in adult women. Using a prospective comparative effectiveness trial, we will compare the occurrence of these events at one year in adult women that undergo coronary angiography plus invasive physiological testing rather than standard of care. This study may help improve diagnostic accuracy and inform disease-specific treatment for women with nonobstructive coronary disease, as well as decrease healthcare utilization costs.

Open Access

This Article is Open Access