Interferon-activated neutrophils characterize coronary microvascular dysfunction in women with ANOCA

In women with ANOCA, coronary microvascular dysfunction (CFR<2.5) is linked to higher NT-proBNP (234 [136–416] vs 112 [79–200] pg/ml) and interferon-activated neutrophil expansion.

• Why it matters: Coronary microvascular dysfunction is a common driver of ischemic symptoms in women with non-obstructive coronary arteries, and neutrophil-driven vascular inflammation may be a key mechanism.
• What they did: In a cross-sectional study of 123 ANOCA patients (84% women), the team measured blood counts and neutrophil activation (AQUIOS, n=76), profiled neutrophils by single-cell RNA-seq (n=11), and performed bulk RNA-seq on guidewire-derived endothelial cells (n=7).
• The result: Lower CFR was associated with higher neutrophil-related immune markers and an inverse relationship between CD62Ldim activated neutrophils and CFR; IFN-activated neutrophils expanded with low CFR and corresponded to endothelial pathway shifts.

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