Insulin Resistance and Coronary Microvascular Dysfunction in Patients with Myocardial Ischemia and Non-obstructive Coronary Artery Disease

Launched by AZIENDA OSPEDALIERA UNIVERSITARIA INTEGRATA VERONA · Sep 12, 2024

Keywords

ClinConnect Summary

This clinical trial is studying the relationship between problems with small blood vessels in the heart—known as coronary microvascular dysfunction—and insulin resistance in patients who experience chest pain but do not have significant blockages in their coronary arteries. The researchers want to understand how these two conditions are connected, which could help improve treatment for patients with certain types of heart issues.

To be eligible for this study, participants should be over 18 years old and have experienced chest pain with signs of reduced blood flow to the heart. They should also be willing to provide consent to participate. Patients with certain conditions, like significant blockages in their arteries, a history of heart attacks or diabetes, and those who are pregnant, among other exclusions, cannot participate. Those who join the study will undergo tests to assess their heart and insulin sensitivity, and they will be monitored for two years to track their health and any changes. This study aims to gather important information that could lead to better care and understanding of heart health in patients with these specific conditions.

Gender

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Eligibility criteria

• Inclusion Criteria:
• • Aged over 18 years.
• • Cardiac chest pain with evidence of myocardial ischemia at noninvasive myocardial stress imaging and clinical indication to diagnostic coronary angiography
• • Willing and able to give informed consent for participation in the study
• Exclusion Criteria:
• • Obstructive CAD (defined as more than 70% luminal stenosis and/or FFR ≤0.80 in 1 or more epicardial vessels).
• • History of previous myocardial infarction, percutaneous revascularization or coronary-aortic bypass graft (CABG) surgery.
• • Diagnosis of type II diabetes.
• • BMI ≥ 35 kg/m2.
• • Stage IV and V of chronic kidney disease (eGFR ≤ 30 ml/min, estimated through CKD - EPI Creatinine Equation).
• • Allergy or other contraindication to iodinated contrast and/or gadolinium and/or adenosine.
• • Chronic resting O2 saturation ≤ 85%.
• • Pregnancy or suspected pregnancy.