The evidence above demonstrates that microvascular dysfunction is an important determinant of patient prognosis, which however remains poorly classified. Given the high burden of disease and the severity of the functional impairment in these patients, the lack of a clear definition for this disease has a potentially large clinical importance. It is important to better describe the phenotype of these patients, identify the predictors of prognosis, and determine the impact of diagnosis.
The study is designed as prospective registry. Patients with angina CCS II-IV undergoing assessment of microvascular function will be enrolled. The study does not interfere with the medical standards at the sites with regards to patient treatment or follow-up care. Study duration and schedule The duration of this study is expected to be 7 years. The subject recruitment is planned to start in January 2020 and end in January 2022. The actual overall study duration or subject recruitment period may differ from these time periods. Per-patient, the duration of participation will be up to 5 years. Patients will be evaluated at hospital discharge, at 12 months and 5 years (the latter two as telephone contacts). Number of subjects and study centers It is planned to enroll 1000 subjects in the registry based on power calculations as described. Recruitment and treatment of subjects is expected to be performed in 10 study centers. Primary endpoint The primary endpoint is the composite of cardiovascular death, myocardial infarction, rehospitalization for angina or heart failure, and unplanned coronary angiography at 12 months. Secondary endpoints Each of the components of the primary endpoint Seattle Angina Questionnaire SAQ-7 Physical limitation scale SAQ-7 angina stability scale SAQ-7 angina frequency scale SAQ-7 angina quality of life EQ-5D-5L Beck depression inventory The SAQ-7 "angina frequency" domain has been shown to correlate to improvements in microvascular function in the WISE study. SAQ-7-7 has been also used in a number of studies, including the ISCHEMIA study. Other patient questionnaires are also standardized tests for the assessment of quality of life, depression and symptom severity in coronary artery disease studies.
Study Type
OBSERVATIONAL
Enrollment
1,000
The pressure/temperature wire allows assessing coronary flow reserve, intracoronary pressure, and coronary flow to calculate multiple parameters of coronary macro- and microvascular function.
Universitätsmedizin Mainz
Mainz, RLP, Germany
RECRUITINGPrognostic impact of resting resistances
The impact of resting resistances (expressed as Mean Transit Time, i.e. time for a saline bolus to reach the wire thermistor times distal pressure) on the incidence of patient-oriented outcomes (composite of cardiovascular death, myocardial infarction, rehospitalization for angina or heart failure and unplanned coronary angiography) at 12 months
Time frame: 12 months
Correlation between SAQ measures and IMR
Correlation of IMR with Seattle Angina Questionnaire, including each of its components (SAQ-7 Physical limitation scale, SAQ-7 angina stability scale, SAQ-7 angina frequency scale, SAQ-7 angina quality of life) at 6 months, 1 year and yearly to 5 years
Time frame: 6 months, 1 year and yearly to 5 years.
Correlation between depression and IMR
Correlation of IMR with Beck depression inventory scores
Time frame: 6 months, 1 year and yearly to 5 years.
Correlation between physical ability and IMR
Correlation of IMR with parameters of 5-EQ-EL
Time frame: 6 months, 1 year and yearly to 5 years.
Distribution of mean transit time (Tmn)
Distribution of Tmn (seconds).
Time frame: At inclusion
Distribution of index of microvascular resistances (IMR)
Distribution of IMR, units.
Time frame: At inclusion
Distribution of aortic and distal pressure
Distribution of Pa (aortic pressure) and Pd (distal arterial pressure) in mmHg.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: At inclusion