INOCA Spanish National Registry

NCT ID: NCT06327672

Last Updated: 2024-03-28

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

1000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-03-24

Study Completion Date

2026-03-31

Brief Summary

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Coronary atherosclerosis is the most common cause of ischaemic heart disease. About 40-50% of patients with symptoms and documented ischaemia on non-invasive tests do not show obstructive coronary artery disease on coronary angiography. This cause of ischaemic heart disease called INOCA (Ischemic Non-Obstructive Coronary Artery), far from having a benign prognosis, is associated with an increase in major adverse cardiac events (MACE) as well as increased functional limitation. The current European Society of Cardiology clinical practice guidelines for the management of chronic coronary syndrome establish for the first time a IIa recommendation for the invasive analysis of coronary flow reserve (CFR) and microvascular resistance index (MRI) in symptomatic patients with INOCA. The acetylcholine (Ach) test, based on intracoronary (ic) administration, is established as indication IIb for the assessment of micro or macrovascular vasospasm in patients with suspected vasospastic angina (VSA) (4). A national multicentre registry would allow us to determine the prevalence of INOCA and its different endotypes in our setting.

Detailed Description

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Multicentre, observational, longitudinal, prospective study on INOCA patients undergoing invasive coronary function testing.

Microvascular angina (MVA) is defined according to the standardized diagnostic criteria of COVADIS (Coronary Vasomotion Disorders International Study Group): symptoms of myocardial ischaemia, unobstructed coronary arteries and demonstrated coronary microvascular dysfunction (CFR \< 2 and/or IMR \>25), or microvascular spasm on Ach test. Diagnosis of coronary microvascular spasm requires provocation and reproduction of symptoms, ischaemic EKG changes, in the absence of epicardial spasm during ACh testing. The diagnosis of VSA requires that 3 conditions are met during ACh testing: 1) clinically significant epicardial vasoconstriction (≥90%); 2) reproduction of chest pain; and 3) ischaemic EKG changes.

Definition of adverse events: Myocardial infarction (MI) will be defined according to the fourth universal definition and subclassified according to type. Ischaemia revascularization will be defined as all percutaneous coronary intervention (PCI) or Coronary Artery Bypass Grafting (CABG) occurring after the baseline procedure and justified by recurrent symptoms or objective evidence of significant ischaemia on non-invasive stress tests. Heart failure will be defined as a hospital admission \> 24 hours with any of the following symptoms and signs: worsening dyspnea, fatigue, fluid overload, pulmonary oedema, elevated venous pressure and need for intravenous diuretics or inotropics. Visits to the emergency department for chest pain will be considered to be those in which there is suspicion of a coronary cause.

All events will be identified and quantified from patient records, including inpatient ward admissions and emergency department visits.

Conditions

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Non-Obstructive Coronary Atherosclerosis Ischemia Coronary Disease

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* Patients \> 18 years.
* Anginal symptoms.
* Anginal equivalent with positive myocardial ischaemia test.
* Absence of obstructive coronary artery disease (diameter stenosis \<50% or \>50% with a FFR\>0.80).
* Patients undergoing invasive coronary function test.
* Signed informed consent.

* Patients with moderate-severe valvular heart disease.
* Patients with structural heart disease.
* Elevation of markers of myocardial necrosis.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital San Carlos, Madrid

OTHER

Sponsor Role collaborator

Fundación de Investigación Biomédica - Hospital Universitario de La Princesa

OTHER

Sponsor Role collaborator

Hospital Universitario Virgen de la Arrixaca

OTHER

Sponsor Role collaborator

University Hospital Gregorio Marañón

OTHER

Sponsor Role collaborator

Hospital Clínico Universitario de Valladolid

OTHER

Sponsor Role collaborator

Hospital Universitario Puerta del Mar

OTHER

Sponsor Role collaborator

Hospital Universitari de Bellvitge

OTHER

Sponsor Role collaborator

Hospital Universitario La Fe

OTHER

Sponsor Role collaborator

Hospital Clínico Universitario de Valencia

OTHER

Sponsor Role collaborator

Hospital Universitario La Paz

OTHER

Sponsor Role collaborator

Hospital General Universitario de Alicante

OTHER

Sponsor Role collaborator

Complejo Hospitalario Universitario de Huelva

OTHER

Sponsor Role collaborator

Hospital General Universitario de Castellón

OTHER

Sponsor Role collaborator

Hospital de Manises

OTHER

Sponsor Role collaborator

Hospital Clinic of Barcelona

OTHER

Sponsor Role collaborator

Hospital Miguel Servet

OTHER

Sponsor Role collaborator

Hospital Clínico Universitario Lozano Blesa

OTHER

Sponsor Role collaborator

Hospital Donostia

OTHER

Sponsor Role collaborator

Hospital General Universitario Elche

OTHER

Sponsor Role collaborator

Hospital Universitario Virgen del Rocio

UNKNOWN

Sponsor Role collaborator

Hospital de la Ribera

OTHER

Sponsor Role collaborator

Hospital de la Santa creu i Sant Pau - Barcelona

OTHER

Sponsor Role collaborator

Hospital Virgen de la Salud

OTHER

Sponsor Role collaborator

Hospital Universitario San Juan de Alicante

OTHER

Sponsor Role collaborator

Hospital Universitario de Torrevieja

UNKNOWN

Sponsor Role collaborator

University Hospital of the Nuestra Señora de Candelaria

OTHER

Sponsor Role collaborator

Hospital de Basurto

OTHER

Sponsor Role collaborator

Hospital Universitario Ramon y Cajal

OTHER

Sponsor Role collaborator

Hospital Universitario Fundación Jiménez Díaz

OTHER

Sponsor Role collaborator

Puerta de Hierro University Hospital

OTHER

Sponsor Role collaborator

Hospital Universitario 12 de Octubre

OTHER

Sponsor Role collaborator

University of Salamanca

OTHER

Sponsor Role collaborator

Hospital Universitario Marqués de Valdecilla

OTHER

Sponsor Role collaborator

Hospital Clinico Universitario de Santiago

OTHER

Sponsor Role collaborator

Complexo Hospitalario Universitario de A Coruña

OTHER

Sponsor Role collaborator

Eva Rumiz González

OTHER

Sponsor Role lead

Responsible Party

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Eva Rumiz González

Principal Investigator

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Hospital Universitario de la Princesa

Madrid, , Spain

Site Status RECRUITING

Hospital Universitario Virgen de Arrixaca

Murcia, , Spain

Site Status RECRUITING

Hospital General Universitario de Valencia

Valencia, , Spain

Site Status RECRUITING

Countries

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Spain

Central Contacts

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Eva Rumiz, MD, PhD

Role: CONTACT

+34 963131800 ext. 446812

Facility Contacts

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Fernando Rivero Crespo, MD

Role: primary

Ramón Lopez Palop, MD

Role: primary

Eva Rumiz Gonzalez, MD, PhD

Role: primary

+34 626068935

References

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Rumiz E, Rivero F, Perez A, Nau G, Romero M, Solana S, Jurado A, Fuertes G, Pardo A, Gutierrez-Barrios A, Casanova J, Oteo JF, Frutos A, Salvatella N, Cardenal R, Sabatel F, Cortes C, Valero E, Rodriguez R, Gutierrez E, Lopez-Palop R, Escaned J. ESP-INOCA: Rationale and design of a national multicentre registry for prognostic stratification in patients with suspected myocardial ischaemia and non-obstructive coronary arteries. Int J Cardiol. 2025 Aug 29;442:133845. doi: 10.1016/j.ijcard.2025.133845. Online ahead of print.

Reference Type DERIVED
PMID: 40886802 (View on PubMed)

Other Identifiers

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162023

Identifier Type: -

Identifier Source: org_study_id

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