Finding the Invasive Haemodynamic Threshold for Symptom Relief in Stable Angina

Launched by IMPERIAL COLLEGE LONDON · Jul 13, 2022

Keywords

ClinConnect Summary

The ORBITA-FIRE trial is studying how to better understand and measure the symptoms of stable angina, which is chest pain or discomfort caused by reduced blood flow to the heart. Researchers want to find specific pressure levels in the heart's blood vessels that relate to these symptoms, helping to improve how we diagnose and treat this condition. The study will include 58 patients who have been experiencing angina and meet certain medical criteria.

To participate in this trial, individuals need to be between 65 and 74 years old and should have evidence of significant narrowing in one of their heart's arteries, either from imaging tests or other assessments that show their heart isn't getting enough blood flow during exercise or stress. Participants will undergo various tests to measure their heart function and will be closely monitored throughout the study. This trial is an important step in helping doctors understand how to relieve symptoms for those suffering from stable angina and may lead to better treatment options in the future.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Eligibility for percutaneous coronary intervention (PCI) due to angina or angina-equivalent symptoms on exertion
• * Anatomical evidence of significant single-vessel coronary stenosis defined by either:
• • ≥70% stenosis on invasive coronary angiography (ICA)
• • Severe stenosis on CT coronary angiography (CTCA)
• * Physiological evidence of ischaemia with a positive test on at least one of the following:
• • Stress echocardiography
• • Cardiac magnetic resonance perfusion
• • Myocardial perfusion scintigraphy
• • Invasive metrics of coronary physiology
• Exclusion Criteria:
• • Age \<18 years
• • Recent acute coronary syndrome
• • Previous coronary artery by-pass graft
• • Significant left main stem disease
• • Multivessel disease (defined as \>50% angiographic stenosis in other vessels)
• • Chronic total occlusion in the target artery
• • Moderate to severe valvular disease
• • Moderate to severe left ventricular impairment
• • Chronotropic incompetence with a pacemaker
• • Contraindication to PCI or a drug-eluting stents
• • Contraindication to antiplatelet therapy
• • Contraindication to adenosine
• • Moderate to severe respiratory disease
• • Physical inability to exercise
• • Pregnant
• • Inability to consent