Coronary Microvascular Disease, Myocardial Infarction
Conditions
Brief summary
The purpose of this research is to find out if patients with Type 2 Myocardial Infarction (T2MI) without significant epicardial coronary artery disease (CAD) have a greater chance of having coronary microvascular disease (CMD).
Interventions
DIAGNOSTIC_TESTCoronary angiogram with coronary reactivity testing (CRT)
CRT is an angiography procedure (using X-ray) to examine the small blood vessels in the heart and how they respond to three drugs (adenosine, acetylcholine and nitroglycerin) as per clinical protocol.
Sponsors
Mayo Clinic
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Ability to give informed consent * Structurally normal heart (normal LV and RV function, no more than mild valvular heart disease) * For controls: atypical chest pain with indication for CMD testing * For T2MI: meet criteria for T2MI according to the 4th Universal definition of MI (rise/fall of troponin with at least 1 value \>99th centile+ evidence of symptoms or signs of myocardial ischemia)
Exclusion criteria
* Acute coronary event (evidence of plaque rupture, fissure or dissection on coronary angiogram) * Known to have angiographically significant CAD/pressure wire positive for epicardial CAD * Inability to receive heparin products * Allergy/contraindication to acetylcholine/adenosine/nitroglycerine products * Prior coronary artery bypass grafting * Pregnancy (if sexually active woman of reproductive age, need negative pregnancy test prior to proceeding with coronary angiography - this is standard of care in cath lab) * Asthma with prior ICU admission due to bronchospasm/need for invasive ventilation
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Coronary Flow Reserve (CFR) | Baseline | The CFR will be calculated as a ratio of coronary flow at peak hyperemia /coronary flow at rest. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Backward Compression Wave (BCW) | Baseline | The BCW is a measure of increased microvascular resistance during systole. |
Countries
United States
Contacts
CONTACTIschemic Heart Disease Research Team
CONTACTClaire Raphael, MBBS, PhD
PRINCIPAL_INVESTIGATORClaire Raphael, MBBS, PhD.
Mayo Clinic
Outcome results
None listed