The Anti-Anginal Effects of N-Acetylcysteine (NAC) in Patients with Angina and Non-Obstructive Coronary Arteries (ANOCA)

Launched by UNIVERSITY OF ADELAIDE · Mar 16, 2025

Keywords

ClinConnect Summary

This clinical trial is investigating whether a medication called N-acetylcysteine (NAC) can help reduce the number of angina attacks in women who have chest pain but do not have significant blockages in their coronary arteries, a condition known as ANOCA (Angina with Non-Obstructive Coronary Arteries). The study will also look at how NAC affects the participants’ overall health and quality of life. Eligible participants must be women aged 18 or older who experience chest pain at least three times a week and do not have obstructive coronary artery disease.

During the trial, participants will take either NAC or a placebo (an inactive treatment) for four weeks, followed by a two-week break, and then switch to the other treatment for another four weeks. Throughout the study, participants will keep a diary to track their angina episodes and complete questionnaires about their health and quality of life. This trial is not yet recruiting participants, so if you're interested, it's best to stay tuned for further updates.

Gender

FEMALE

Eligibility criteria

• Inclusion Criteria:
• • 1. Provision of informed consent prior to any study specific procedures
• • 2. Female patients aged ≥18 years
• • 3. No obstructive CAD (defined as either absence of epicardial lesions with ≥50% luminal narrowing in any coronary artery segment on coronary angiography or normal findings on computed tomography (CT) angiogram, indicating the absence of significant stenosis) to account for chest pain symptoms.
• • 4. Chest pain occurring ≥3 times/week in the preceding two weeks.
• Exclusion Criteria:
• • 1. Known allergy to NAC or its components.
• • 2. Acute myocardial infarction admission within the preceding month (hospital admission for prolonged angina paint associated with a cardiac troponin level above the 99th percentile, with a subsequent rise or fall).
• 3. Secondary causes of angina including:
• • i. clinically significant anaemia (haemoglobin \<100g/dL) ii. uncontrolled atrial fibrillation (ventricular response rate \>108bpm) iii. haemodynamically significant aortic stenosis (mean valve gradient ≥40mmHg) d) Known concomitant disease with life expectance of less than 1 year. e) Abnormalities in liver function tests suggesting hepatic impairment (ALT and/or AST 2 x upper limit of normal (ULN) or ALP 2 x ULN or Bilirubin 1.5 x ULN) f) Severe renal impairment (eGFR \<30mL/min) or on dialysis. g) Pregnancy or lactation. h) Untreated hypertension i) Unwilling, or unable, to give informed consent, including due to severe psychiatric conditions affecting informed consent process or compliance.
• • j) History of substance abuse. k) Currently taking Chloroquine. l) Serious or unstable medical conditions that may interfere with the study, as determined by the PI.
• • m) Concomitant participation in another clinical trial or research study (except where in the opinion of the PI, the participant could benefit from enrolling in another trial)