Personalized Medicine Using Coronary Microvascular Function Measured in Patient With Percutaneous Coronary Intervention in Angina

Launched by UNIVERSITY HOSPITAL, GRENOBLE · Dec 22, 2021

Keywords

ClinConnect Summary

This clinical trial is studying how personalized medicine can help patients with coronary microvascular disease (CMVD) who experience chest pain, known as angina. Researchers want to find out if a special test called the index of microcirculatory resistance (IMR) can guide treatment decisions after assessing the larger blood vessels in the heart. The goal is to see if this tailored approach can reduce symptoms and improve the quality of life for patients with stable coronary artery disease (CAD).

To participate in this trial, you need to be over 18 years old and experiencing angina. You must also be scheduled for a specific heart test called invasive coronary angiography, which looks at your heart's blood vessels. If you're eligible, the study will involve measuring both the flow in your larger coronary arteries and the function of your smaller blood vessels to determine the best treatment for you. It's important to note that certain medical conditions, such as severe kidney problems or pregnancy, may make you ineligible for the study. Participants will provide written consent and can expect close monitoring throughout the process to ensure their safety and well-being.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Patient over 18 years
• • Symptomatology of angina pectoris
• • Receiving invasive coronary angiography
• * FFR and microcirculatory resistance index (MRI) measurement for at least one epicardial lesion ≥ 50% :
• • For lesions with FFR ≤ 0.8, revascularization with the XIENCE Sierra stent and its evolutions will be performed. Optimization of this epicardial revascularization will be evidenced by a post-PCI FFR \> 0.8 on all major trunks and if an FFR measurement is not performed, absence of 50% or greater stenosis on two orthogonal views by quantitative coronary angiography \[QCA\] at the revascularization site.
• • For lesions with FFR \> 0.8 revascularization will not be performed
• • Written informed consent
• Exclusion Criteria:
• • A non-coronary indication for coronary angiography, e.g. valve disease, hypertrophic obstructive cardiomyopathy.
• • Severe renal dysfunction (GFR \< 30 ml/min)
• • Contraindications for adenosine: asthma, Second or third degree AV block without pacemaker or sick sinus syndrome, Systolic blood pressure less than 90 mm Hg, Recent use of dipyridamole or drugs containing dipyridamole, Methyl xanthenes such as caffeine aminophylline or theobromine block the effect of adenosine and should be stored at least 12 hours before testing, Known hypersensitivity to adenosine.
• • Pregnant women, parturients and breastfeeding mothers
• • Persons of full age who are subject to a legal protection measure or who are unable to express their consent
• • Patient in a period of exclusion from another study
• • Patient under administrative or judicial supervision