Study of Personalized Drug Treatment Based on Coronary Microcirculation Testing Compared to Standard Care in Adults With Chronic Coronary Syndrome and Ischemia Without Blockages

What this Trial Is About

Researchers are evaluating whether tailoring drug treatment based on detailed analysis of coronary microvascular function improves quality of life for adults with ischemia but no significant blockages in their coronary arteries. This study focuses on patients with chronic coronary syndrome who continue to experience symptoms despite standard care. It aims to compare endotype-guided pharmacotherapy with usual treatment over a three-month period to see if it better relieves symptoms and improves patient-reported angina scores. Participants will be randomly assigned to one of two groups an intervention group receiving medication targeted to their specific coronary microvascular dysfunction type identified through invasive and non-invasive tests, or a control group receiving standard drug therapy. All participants undergo comprehensive heart function assessments, including intracoronary acetylcholine testing, measurements of coronary flow reserve and microvascular resistance with specialized equipment, and echocardiographic coronary flow velocity reserve. The control group will cross over to receive endotype-guided treatment after three months, and both groups will have follow-up evaluations at three and six months. During the study, participants will provide blood and urine samples to analyze biomarkers related to inflammation and oxidative stress. They will complete questionnaires assessing quality of life, anxiety, and functional capacity, and perform a six-minute walk test at baseline and follow-up visits. The main outcome is the change in angina symptoms measured by the Seattle Angina Questionnaire after three months. Secondary outcomes include biomarker analysis, diagnostic test accuracy, anxiety scores, and functional status. Safety and adverse events will also be monitored throughout the study period, which is expected to end in March 2028.

COronoary Microcirculation Analysis NETwork