Angina syndromes and no obstructive coronary artery disease (ANOCA)
Conditions
Interventions
Intracoronary function testing guided therapy
Sponsors
Academic Medical Research B.V.
Eligibility
Inclusion criteria
Inclusion criteria: - Age = 18 years. - Patient referred for elective coronary angiography, at the discretion of the treating physician, for suspected angina (and/or angina-equivalent) symptoms. - Absence of obstructive coronary artery disease evident in a main coronary artery (diameter stenosis0.89, or FFR >0.80).
Exclusion criteria
Exclusion criteria: -A noncoronary indication for invasive angiography, e.g., valve disease, hypertrophic obstructive cardiomyopathy -A life expectancy of less than 2 years. -Inability to sign an informed consent, due to any mental condition that renders the subject unable to understand the nature, scope, and possible consequences of the trial or due to mental retardation or language barrier. -Potential for non-compliance towards the requirements for follow-up visits.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To assess the effectiveness of a stepwise medical therapy approach guided by coronary function testing in reducing angina burden of patients with angina pectoris and no obstructive epicardial coronary artery disease based on clinically indicated invasive coronary angiography, compared with the control of angina provided by standard clinical care not guided by coronary function testing | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. To identify the relevance of endothelial dysfunction in the spectrum of ANOCA endotypes 2. To evaluate the appropriateness of current criteria for abnormal vasoconstriction and abnormal vasodilatation to sensitively rule out significant abnormalities in coronary function. 3. To compare angiography-derived coronary flow reserve and microvascular resistance versus invasive coronary flow reserve and microvascular resistance. 4. To assess the cost-effectiveness of a stepwise medical therapy approach guided by coronary function testing compared with standard clinical care not guided by coronary function testing. 5. To assess the prognostic value of biomarkers (hs-troponin, NTproBNP, CRP). at baseline across the ANOCA-endotypes. 6. To assess sex differences across the various ANOCA-endotypes and the impact of sex differences on diagnosis, treatment, and health status. | — |
Contacts
Public ContactCoen Boerhout
Amsterdam UMC
Outcome results
None listed