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Turkish Society of Cardiology
Young Cardiologists
President
Dr. Muzaffer Değertekin
Coordinator for the
Board of Directors
Dr. Ertuğrul Okuyan
Coordinator for the
Board of Directors
Dr. Can Yücel Karabay
Members
Dr. Adem Aktan
Dr. Gülşah Aktüre
Dr. Bayram Arslan
Dr. İnanç Artaç
Dr. Ahmet Oğuz Aslan
Dr. Görkem Ayhan
Dr. Ahmet Anıl Başkurt
Dr. Özkan Bekler
Dr. Oğuzhan Birdal
Dr. Yusuf Bozkurt Şahin
Dr. Serkan Bulgurluoğlu
Dr. Ümit Bulut
Dr. Veysi Can
Dr. Mustafa Candemir
Dr. Murat Çap
Dr. Göksel Çinier
Dr. Ali Çoner
Dr. Yusuf Demir
Dr. Ömer Furkan Demir
Dr. Murat Demirci
Dr. Ayşe İrem Demirtola Mammadli
Dr. Süleyman Çağan Efe
Dr. Mehmet Akif Erdöl
Dr. Kubilay Erselcan
Dr. Kerim Esenboğa
Dr. Duygu Genç
Dr. Kemal Göçer
Dr. Elif Güçlü
Dr. Arda Güler
Dr. Duygu İnan
Dr. Hasan Burak İşleyen
Dr. Muzaffer Kahyaoğlu
Dr. Sedat Kalkan
Dr. Yücel Kanal
Dr. Özkan Karaca
Dr. Ahmet Karaduman
Dr. Mustafa Karanfil
Dr. Ayhan Kol
Dr. Fatma Köksal
Dr. Mevlüt Serdar Kuyumcu
Dr. Yunus Emre Özbebek
Dr. Ahmet Özderya
Dr. Yasin Özen
Dr. Ayşenur Özkaya İbiş
Dr. Çağlar Özmen
Dr. Selvi Öztaş
Dr. Hasan Sarı
Dr. Serkan Sivri
Dr. Ali Uğur Soysal
Dr. Hüseyin Tezcan
Dr. Nazlı Turan
Dr. Berat Uğuz
Dr. Örsan Deniz Urgun
Dr. İdris Yakut
Dr. Mustafa Yenerçağ
Dr. Mehmet Fatih Yılmaz
Dr. Yakup Yiğit
Dr. Mehmet Murat Yiğitbaşı
Bulletin Editors
Dr. Muzaffer Değertekin
Dr. Can Yücel Karabay
Dr. Muzaffer Kahyaoğlu
Contributors
Dr. Ahmet Caner Canpolat
Dr. Aysu Oktay
Dr. Hadi Verdiyev
Dr. Kemal Göçer
Dr. Mehmet Altunova
Dr. Mehmet Murat Yiğitbaşı
Dr. Merve Kapçık
Dr. Muhammed Ali Söyler
Dr. Muhammet Ali Ekiz
Dr. Mustafa Yenerçağ
Dr. Mustafa Yılmaz
Dr. Özkan Karaca
Dr. Ramazan Furkan Demirkıran
Dr. Seda Kurat Güldoğmuş
Dr. Sefa Sarı
Dr. Selim Süleyman Sert
Dr. Serkan Bulguroğlu
Dr. Ülkü Nur Koç
Dr. Yücel Kanal
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A Randomised Trial of Coronary Function Testing-Guided Treatment vs Standard Care in ANOCA (ILIAS ANOCA)Türk Kardiyoloji Derneği Genç Kardiyologlar Bülteni - A Randomised Trial of Coronary Function Testing-Guided Treatment vs Standard Care in ANOCA (ILIAS ANOCA) (Dr. Özkan Karaca)Prepared by: Dr. Özkan Karaca
Study Title: A Randomised Trial of Coronary Function Testing-Guided Treatment vs Standard Care in ANOCA (ILIAS ANOCA)
Conference: EuroPCR 2025
Link: https://media.pcronline.com/diapos/EuroPCR2025.pdf
Introduction:
Patients presenting with angina but no obstructive coronary artery disease (ANOCA) form a large subset of those undergoing invasive coronary angiography. Coronary vasomotor disorders—including epicardial and microvascular spasm—are common underlying mechanisms, yet often remain undiagnosed and empirically treated.
Objective:
The ILIAS ANOCA trial aimed to evaluate whether a personalized treatment strategy guided by ad-hoc coronary function testing (CFT) during angiography improves angina-related quality of life and symptom burden compared to standard care over a 6-month period.
Methods:
- 153 patients without obstructive CAD were enrolled and randomized 1:1.
- CFT included coronary flow reserve (CFR <2.5), hyperemic microvascular resistance (HMR >2.5 mmHg/cm/s), and acetylcholine provocation.
- Patients were randomized to receive either disease-specific therapy based on CFT (n=77) or standard care (n=76).
- Primary endpoint: change in Seattle Angina Questionnaire Summary Score (SAQSS) at 6 months.
Results:
- Coronary vasomotor dysfunction was diagnosed in 78% of patients.
- SAQSS increased by +11.6 points in the intervention group (p=0.001), compared to +4.2 in the control group (p=0.226).
- CFT was completed in 21±6 minutes without procedural complications.
- No major adverse cardiac events occurred during follow-up.
Conclusions:
The ILIAS ANOCA study demonstrated that ad-hoc CFT is a safe and feasible diagnostic strategy during routine coronary angiography. CFT-guided personalized therapy significantly improves quality of life and angina symptoms, supporting the early use of physiologic testing in the ANOCA population.
Comment:
The ILIAS ANOCA trial elegantly addresses a major diagnostic gap in the management of ANOCA patients by demonstrating the safety, feasibility, and clinical benefit of ad-hoc coronary function testing during angiography. From a cardiologist’s perspective, the study supports a shift from empirical therapy to evidence-based, physiology-guided treatment in a population that is often misclassified and undertreated. Broader implementation may hinge on training and resource allocation, but the implications for precision medicine are substantial.
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