Study of Ischemia in Patients with Non-Obstructive Coronary Artery Disease A Local Prospective Registry at Federico II University

What this Trial Is About

Researchers are investigating the presence of ischemia with non-obstructive coronary artery disease INOCA in patients undergoing clinically indicated coronary angiography. The study aims to classify patients based on different INOCA subtypes identified through physiological testing and to assess the impact of tailored treatments on angina symptoms, quality of life, cardiac hospitalizations, and coronary interventions over a five-year follow-up period. Participants with angina or positive stress tests who show non-obstructive coronary artery disease during angiography will undergo detailed functional assessments. These include fractional flow reserve FFR, instantaneous wave-free ratio iFR, and resting full-cycle ratio RFR for lesions considered more than 50% narrowed. For patients with less than 50% stenosis or negative functional tests, additional measurements of coronary flow reserve CFR and index of microvascular resistance IMR will be performed. If CFR and IMR indicate normal values, an acetylcholine test will be done to detect coronary spasms. Throughout the study, participants will be monitored for major adverse cardiac events MACE, angina severity, and quality of life at 12 and 60 months. The study includes collecting clinical data from coronary angiography, physiological tests, and symptom assessments. This prospective registry aims to improve understanding of INOCA and evaluate how stratified therapies affect patient outcomes over time.

INOCA-NA a Local Prospective Registry