PARIS – Patients with angina and non-obstructive coronary arteries (ANOCA) can be safely and feasibly given routine ad-hoc coronary function testing (CFT) during invasive coronary angiography (ICA), according to results from the ILIAS ANOCA trial. Additionally, quality of life increases in patients whose CFT results are utilized and used for disease management post-procedure. These data were presented by Tim Van De Hoef, MD, PhD, from the University Medical Center Utrecht, The Netherlands, during a Late-Breaking Trial session on Thursday at the EuroPCR Congress 2025. ANOCA is present in up to 50% of patients undergoing ICA. Coronary vascular disorders can be identified in roughly 90% of patients with ANOCA using CFT. Early diagnosis of these disorders may improve quality of life in this patient population. In the ILIAS ANOCA (Inclusive Invasive Physiological Assessment in Angina Syndromes – Angina With No Obstructive Coronary Artery Disease) trial, patients with obstructive coronary artery disease (CAD) were excluded, and the remaining patients were randomized be blind to the results of their comprehensive CFT or given full disclosure and tailored medical therapy advice. The mean between-group differences in the change of the Seattle Angina Questionnaire summary score (SAQSS) from baseline to 6-month follow-up was the primary outcome in this study. A total of 255 patients were evaluated for this trial, and 102 were excluded due to obstructive CAD. For analysis, 153 patients were included (77 to the intervention group, 76 to the control group). SAQSS scores significantly improved at the 6-month follow-up, moreso in the intervention group than the control group (intervention effect: 9.4Units, 95% confidence interval [CI]=3.9-14.9, p=0.001). No major adverse cardiovascular events were reported at the 6-month mark. A total of 78% of patients were observed to have coronary vasomotor dysfunction. Overall, coronary function testing was both safe and feasible in ANOCA patients who underwent ICA, and patients who received a diagnosis and additional medical treatment with the CFT-provided information had better quality of life at 6-months follow-up. Image Credit: Copyright EuroPCR 2025 Image Caption: Tim Van De Hoef, MD, PhD, speaks during a press conference on Tuesday at EuroPCR Congress 2025 in Paris.