Efficacy of Targeted Medical Therapy in Angina and Nonobstructive Coronary Arteries

Launched by STANFORD UNIVERSITY · May 16, 2024

Keywords

ClinConnect Summary

This clinical trial is studying whether a specific type of medication can help improve symptoms and quality of life for patients experiencing chest pain, known as angina, especially when their coronary arteries are not blocked. The trial will involve patients who have undergone tests to determine the cause of their chest pain and are referred to the Stanford University Hospital. Participants will receive either the targeted medication or a placebo (a harmless pill with no active ingredients) for four weeks after an initial adjustment period.

To be eligible for this study, participants should be adults with stable angina who have been tested and found not to have significant blockages in their coronary arteries. They must also show certain conditions related to their chest pain, like spasms in the arteries or reduced blood flow. Throughout the trial, participants will fill out questionnaires to help researchers understand how their condition and quality of life may change. This is a unique opportunity for those with specific types of angina to potentially benefit from new treatment options while contributing to important medical research.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • All patients with stable angina referred to the Stanford University Hospital cardiac catheterization laboratory for clinically indicated coronary function testing are eligible for inclusion into the study.
• Specific inclusion criteria for randomization:
• • Absence of significant epicardial coronary artery disease on angiography
• • Fractional flow reserve \> 0.80
• And ≥ 1 of the following:
• • Epicardial coronary spasm on acetylcholine testing
• • Microvascular spasm on acetylcholine testing
• • Coronary flow reserve \< 2.5
• • Index of microcirculatory resistance ≥ 25
• • Myocardial bridge on intravascular ultrasound with dobutamine resting full-cycle ratio ≤ 0.76
• Exclusion Criteria:
• • Acute coronary syndrome less than one week prior to enrolment
• • Cardiomyopathy
• • Contraindications to beta-blockers or calcium channel blockers
• • Baseline systolic blood pressure \< 95 mmHg
• • Baseline heart rate \< 55 bpm