Angina Pectoris, Microvascular Angina
Conditions
Brief summary
Serial assessment of angina status and ischemia on stress echo over one year among patients with moderate ischemia on stress imaging and non-obstructive CAD on coronary CT angiography.
Detailed description
Some people with chest pain are found to have open arteries on angiograms instead of blocked arteries and many, but not all, of these people have abnormal stress tests or other tests showing there is not enough blood flow to the heart. Prior research has not made clear whether chest pain in such patients is due to heart disease or something else, in part because no one has found out whether chest pain and stress test results change in the same direction over time. This study will use two measurements of chest pain and two stress tests, one year apart, to find out if chest pain and abnormal stress tests are both caused by the same problem: not enough blood flow to the heart.The association between angina, ischemia and atherosclerosis severity at baseline will be examined, as will medication effects.
Interventions
OTHERQuality of Life assessment
Seattle Angina Questionnaire and other questionnaires.
PROCEDUREStress imaging
Stress imaging
Sponsors
Duke Clinical Research Institute
Massachusetts General Hospital
NYU Langone Health
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
21 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* Enrolled but not randomized in ISCHEMIA trial * Stress echocardiography used for enrollment\* * No obstructive CAD on study coronary CT angiography (defined as no ≥50% stenosis in a major epicardial vessel) * Ischemic symptoms (chest pain or other potential ischemic equivalent). * Participant is willing to give written informed consent * Age ≥ 21 years
Exclusion criteria
* Inability to comply with protocol * Prior PCI or CABG
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Seattle Angina Questionnaire (SAQ) score | baseline-one year comparison |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Ischemia severity | baseline-one year comparison | — |
| Coronary atherosclerosis severity (comparison with SAQ score and with ischemia severity) | baseline | comparison with SAQ score and with ischemia severity |
| Ischemia severity (comparison with SAQ score and with ischemia severity) | baseline | comparison with SAQ score and with atherosclerosis severity |
| Medical therapy used for angina (comparison with SAQ score and ischemia severity) | one year | comparison with SAQ score and ischemia severity |
| Major adverse cardiac events | one year | death, MI, stroke, cardiovascular hospitalizations/ER visits |
Countries
United States
Outcome results
None listed