Stable angina pectoris
Conditions
Interventions
Sponsors
Eligibility
Inclusion criteria
Inclusion criteria: - A diagnosis of SAP with residual angina symptoms after OMT - Established ischemia (assessed by SPECT, PET, Stress ultrasound, CMR, or cycle ergometry) - Access to a personal computer, laptop or tablet with Internet connectivity at home. - Access to a mobile phone with short message service (SMS) functionality to login to the web application with two-factor authentication.
Exclusion criteria
Exclusion criteria: An echocardiography and coronary angiography (usual care group) or coronary computed tomography (CT)-angiography (CR group) will be performed to exclude high-risk patients with a reduced left ventricular function (i.e. left ventricular ejection fraction <35%). After randomisation patients will also be screened for stenosis of the left main coronary artery through computed tomography (intervention group) or coronary angiogram (control group). For these patients previous work revealed the potential prognostic benefit of revascularization, in terms of mortality, also supported by latest guidelines on myocardial revascularization with a class 1A indication for revascularization. Other exclusion criteria include: 1. PCI or CABG in the past year 2. Acute coronary syndrome in past 2 months 3. Angina symptoms at rest or rapidly progressive (i.e. unstable angina) 4. Ischemic threshold <50 watts 5. New-York Heart Association class III-IV heart failure symptoms 6. Advanced chronic kidney failure (i.e. estimated Glomerular Filtration rate <30ml/min) 7. Severe ventricular arrhythmia or exercise-induced arrythmia at baseline testing 8. A comorbidity precluding exercise training (e.g. orthopaedic, neurological or cognitive conditions) or other contra-indications for exercise training.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The primary outcome will be the quantity of angina symptoms (evaluated by the Seattle Angina Questionnaire (SAQ-7)) following the 12-month intervention. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary outcomes include cost-effectiveness, the ischemic threshold during exercise, cardiovascular events, quality of life, fitness, cardiovascular health and psychosocial wellbeing. | — |
Contacts
Radboudumc