Finding the Invasive Haemodynamic Threshold for Symptom Relief in Stable Angina

NCT ID: NCT05459051

Last Updated: 2024-03-06

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

RECRUITING

Total Enrollment

58 participants

Study Classification

OBSERVATIONAL

Study Start Date

2022-09-01

Study Completion Date

2025-04-08

Brief Summary

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ORBITA-FIRE is a randomised, double-blinded, placebo controlled experimental study that will identify the fractional flow reserve (FFR) and non-hyperemic pressure ratio (NHPR) thresholds that correlate with symptoms of angina for 58 patients measured invasively under experimental conditions.

Detailed Description

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Conditions

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Stable Angina

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients with stable angina

* Symptomatic
* Anatomically severe single-vessel coronary artery disease
* Physiological evidence of myocardial ischaemia

Rest-angina physiological assessment

Intervention Type DIAGNOSTIC_TEST

The degree of stenosis required to cause angina at rest will be measured under double-blinded placebo controlled conditions using sequential intracoronary balloon inflations. This will then be correlated with various physiological indices, including FFR and NHPR.

Exercise-angina physiological assessment

Intervention Type DIAGNOSTIC_TEST

The degree of stenosis required to cause angina during exercise will be measured under double-blinded placebo controlled conditions using sequential intracoronary balloon inflations. This will then be correlated with various physiological indices, including FFR and NHPR.

Interventions

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Rest-angina physiological assessment

The degree of stenosis required to cause angina at rest will be measured under double-blinded placebo controlled conditions using sequential intracoronary balloon inflations. This will then be correlated with various physiological indices, including FFR and NHPR.

Intervention Type DIAGNOSTIC_TEST

Exercise-angina physiological assessment

The degree of stenosis required to cause angina during exercise will be measured under double-blinded placebo controlled conditions using sequential intracoronary balloon inflations. This will then be correlated with various physiological indices, including FFR and NHPR.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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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
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Royal Free Hospital NHS Foundation Trust

OTHER

Sponsor Role collaborator

Mid and South Essex NHS Foundation Trust

OTHER

Sponsor Role collaborator

St George's University Hospitals NHS Foundation Trust

OTHER

Sponsor Role collaborator

Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust

OTHER_GOV

Sponsor Role collaborator

Portsmouth Hospitals NHS Trust

OTHER_GOV

Sponsor Role collaborator

Imperial College London

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rasha Al-Lamee, PhD MRCP

Role: PRINCIPAL_INVESTIGATOR

Imperial College London

Locations

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Mid and South Essex NHS Foundation Trust

Basildon, , United Kingdom

Site Status RECRUITING

Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust

Bournemouth, , United Kingdom

Site Status RECRUITING

Imperial College NHS Trust

London, , United Kingdom

Site Status RECRUITING

Royal Free Hospital NHS Foundation Trust

London, , United Kingdom

Site Status RECRUITING

St George's University Hospitals NHS Foundation Trust

London, , United Kingdom

Site Status RECRUITING

Portsmouth Hospitals NHS Trust

Portsmouth, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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Fiyyaz Ahmed-Jushuf, MBBS MRCP

Role: CONTACT

020 7594 5735

Rasha Al-Lamee, PhD MRCP

Role: CONTACT

020 7594 5735

Facility Contacts

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Thomas Keeble

Role: primary

Peter O'Kane

Role: primary

Fiyyaz Ahmed-Jushuf

Role: primary

Tushar Kotecha

Role: primary

James Spratt

Role: primary

Peter Haworth

Role: primary

Other Identifiers

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22HH7546

Identifier Type: OTHER

Identifier Source: secondary_id

P91528

Identifier Type: -

Identifier Source: org_study_id

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