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<p>This letter discusses methodological limitations of a retrospective case-control study evaluating HbA1c, HDL-C, and hemoglobin levels in microvascular angina. Although the findings are clinically interesting, differences in control phenotyping, incomplete CFR assessment, medication confounding, and endotype heterogeneity limit causal interpretation. Prospective, mechanism-based validation is needed before these variables are accepted as therapeutic targets.</p>

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Microvascular angina beyond risk markers: the need for endotype-specific validation

  • 期刊论文

  • 发表日期：

    2026年7月5日

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  • Abdülmelik Birgün,
  • Abdullah Sarıhan,
  • Macit Kalçık

摘要

This letter discusses methodological limitations of a retrospective case-control study evaluating HbA1c, HDL-C, and hemoglobin levels in microvascular angina. Although the findings are clinically interesting, differences in control phenotyping, incomplete CFR assessment, medication confounding, and endotype heterogeneity limit causal interpretation. Prospective, mechanism-based validation is needed before these variables are accepted as therapeutic targets.