Coronary Microvascular Function and CT Coronary Angiography (CorCTCA)

Launched by NHS NATIONAL WAITING TIMES CENTRE BOARD · Mar 19, 2018

Keywords

ClinConnect Summary

The Coronary Microvascular Function and CT Coronary Angiography (CorCTCA) trial is studying the causes of angina, which is chest pain or discomfort, in patients who do not have significant blockages in their coronary arteries. The aim is to understand how abnormal blood flow in the tiny blood vessels of the heart, known as microvascular function, can contribute to this type of angina. The trial includes 250 patients aged 65 and older who experience symptoms of angina but have been found, through a specific heart scan called CT coronary angiography, to have no major blockages or structural heart disease.

Eligible participants will undergo a heart procedure where doctors will test how well their coronary blood vessels function. They will also be part of a random selection process where some will learn the results of their tests immediately, while others will not until later. Doctors will monitor how this information affects treatment decisions. Through this research, the trial aims to shed light on the challenges of diagnosing and treating angina in patients without serious heart disease, ultimately helping to improve patient care.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Symptoms of angina or angina-equivalent informed by the Rose Angina questionnaire.
• • 2. Intermediate or no obstructive coronary disease i.e. no coronary stenosis \>70% in an artery \>2.5 mm, as revealed by CT coronary angiography.
• Exclusion Criteria:
• • 1. A health problem that would explain the angina, e.g. anaemia, moderate-severe aortic stenosis, hypertrophic obstructive cardiomyopathy
• • 2. Obstructive disease evident in a coronary artery (diameter \>2.5 mm), i.e. \>50 - 70% circumferential plaque extending for ≥2 coronary segments, or a stenosis\>70% as revealed by CT coronary angiography
• • 3. Lack of informed consent.
• Exclusion from randomisation in the catheter laboratory:
• • 4. Flow-limiting coronary disease defined by a fractional flow reserve (FFR) ≤0.80 in an artery\>2.5 mm.