Angina, Physiology, Biology (ANgina, FIsiologia BIOlogia)

NCT ID: NCT05374694

Last Updated: 2022-10-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-05-08

Study Completion Date

2023-12-31

Brief Summary

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Relationship between invasive physiological assessment with FFR and IMR and biological markers as micro-RNA's according to coronary vascular compartiment affected (Group 1: Macrovasculature + / Microvasculature +; Group 2: Macrovasculature + / Microvasculature -; Group 3: Macrovasculature - / Microvasculature +; Group 4: Macrovasculature - / Microvasculature -). Also, biological markers will be related with presence of microvascular spasm or macrovascular spasm (Group 5).

Detailed Description

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Patients with chest pain suggestive of angina after ruling out other cardiac and non-cardiac causes, referred for invasive coronary angiography, will be evaluated by coronary angiography and invasive coronary physiological assessment by determining FFR and IMR and by performing a vasoreactivity test with acetylcholine.

A relationship will be established between the invasive physiological assessment with FFR and IMR and biological markers such as micro-RNA's according to the affected coronary vascular compartment (Group 1: Macrovasculature + / Microvasculature +; Group 2: Macrovasculature + / Microvasculature -; Group 3 : Macrovasculature - / Microvasculature +; Group 4: Macrovasculature - / Microvasculature -). In addition, the biological markers will be related to the presence of microvascular spasm or macrovascular spasm (Group 5).

Finally, among other biological markers, the following miRNAs will be compared. These miRNA's present consistent data in the literature about their over or underexpression.

Conditions

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Angina Pectoris

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Group 1

Macrovasculature + (FFR ≤ 0.80) / Microvasculature + (IMR ≥25)

Physiological invasive coronary evaluation

Intervention Type DIAGNOSTIC_TEST

Performance of FFR, IMR and acetylcholine test (Only patients in groups 3 and 4 will undergo the acetylcholine test)

Group 2

Macrovasculature + (FFR ≤ 0.80) / Microvasculature - (IMR \<25)

Physiological invasive coronary evaluation

Intervention Type DIAGNOSTIC_TEST

Performance of FFR, IMR and acetylcholine test (Only patients in groups 3 and 4 will undergo the acetylcholine test)

Group 3

Macrovasculature - (FFR\>0.80) / Microvasculature + (IMR ≥25)

Physiological invasive coronary evaluation

Intervention Type DIAGNOSTIC_TEST

Performance of FFR, IMR and acetylcholine test (Only patients in groups 3 and 4 will undergo the acetylcholine test)

Group 4

Macrovasculature - (FFR\>0.80) / Microvasculature - (IMR \<25)

Physiological invasive coronary evaluation

Intervention Type DIAGNOSTIC_TEST

Performance of FFR, IMR and acetylcholine test (Only patients in groups 3 and 4 will undergo the acetylcholine test)

Group 5

Microvascular spasm (\<90% diameter contraction, Chest pain, ECG changes) or Macrovascular spasm (\>90% diameter contraction, Chest pain, ECG changes)

\*Only patients in groups 3 and 4 will undergo the acetylcholine test.

Physiological invasive coronary evaluation

Intervention Type DIAGNOSTIC_TEST

Performance of FFR, IMR and acetylcholine test (Only patients in groups 3 and 4 will undergo the acetylcholine test)

Interventions

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Physiological invasive coronary evaluation

Performance of FFR, IMR and acetylcholine test (Only patients in groups 3 and 4 will undergo the acetylcholine test)

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Age ≥ 18 years.
2. Patients with chest pain suggestive of angina evaluated by a cardiologist referred for diagnostic coronary angiography and possible coronary intervention.
3. Echocardiogram ruling out noncoronary cardiac causes of chest pain.
4. Informed consent.

Exclusion Criteria

1. Contrast allergy not susceptible to premedication.
2. Severe bronchial asthma or adenosine intolerance.
3. Atrio-ventricular block (≥ 2nd degree) or acetylcholine intolerance.
4. Acute myocardial infarction with ST-segment elevation.
5. Acute myocardial infarction without ST-segment elevation.
6. Cardiogenic shock.
7. Total occlusion of any coronary artery that precludes measurements with pressure-temperature guidewires.
8. Previous coronary artery bypass grafting.
9. Women with the possibility of being pregnant.
10. Renal dysfunction with an estimated glomerular filtration rate \<30 mL/min/1.73m2.
11. Inability to understand the nature of the study and / or sign informed consent.
12. Any other medical condition that, in the opinion of the researcher, may lead to safety issues for patients or may alter the results of the study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Arnau de Vilanova

OTHER

Sponsor Role lead

Responsible Party

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Diego Fernández-Rodríguez

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Hospital Arnau de Vilanova

Lleida, Catalonia, Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Diego Fernández-Rodriguez, MD, PhD

Role: CONTACT

+34-651369729

Facility Contacts

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Diego Fernández-Rodríguez, MD, PhD

Role: primary

651369729

Lucía Matute-Blanco, MD

Role: backup

679252830

Other Identifiers

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CEIC-2665

Identifier Type: -

Identifier Source: org_study_id

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