Actively Recruiting

Phase Not Applicable
Age: 18Years +
All Genders
ID05178914

Personalized Medicine Using Coronary Microvascular Function Measured in Patients With Percutaneous Coronary Intervention for Angina

Led by University Hospital, Grenoble · Updated on 2024-06-24

280

Participants Needed

1

Research Sites

52 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are exploring the role of coronary microcirculation in managing patients with coronary artery disease (CAD), focusing on those with angina. The study evaluates how personalized medicine guided by the index of microcirculatory resistance (IMR), an invasive measure for diagnosing coronary microvascular disease (CMVD), may influence treatment. This approach aims to improve symptoms and quality of life in patients who have undergone percutaneous coronary intervention (PCI) after assessing their epicardial coronary lesions with fractional flow reserve (FFR). Participants are randomly assigned to one of two groups based on their IMR results. Those with an IMR of 25 or higher receive intensified treatment tailored to address microcirculatory damage, while those with an IMR below 25 receive a less intensive treatment adjustment. The control group undergoes a sham procedure where their IMR results are not revealed, and they receive standard medical care according to their physician's preference. Throughout the study, participants are monitored for changes in angina severity, physical limitations, stability, and frequency of symptoms, as well as their perception of disease, treatment satisfaction, dyspnea, quality of life, healthcare use, and major cardiovascular events. These outcomes are assessed at six months and one year, with the primary outcome focusing on the mean difference in angina severity after one year. The study duration and follow-up extend up to one year to evaluate the effects of personalized medicine guided by IMR assessment.

CONDITIONS

Brief Title

Personalized Medicine Using Coronary Microvascular Function Measured in Patient With Percutaneous Coronary Intervention in Angina

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Patient over 18 years
  • Symptoms of angina pectoris
  • Undergoing invasive coronary angiography
  • Measurement of fractional flow reserve (FFR) and microcirculatory resistance index (IMR) for at least one coronary lesion with 50% or greater narrowing
  • Revascularization performed with XIENCE Sierra stent if FFR is 0.8 or less, with post-procedure FFR above 0.8 or no significant stenosis by angiography
  • No revascularization if FFR is greater than 0.8
  • Written informed consent provided
Not Eligible

You will not qualify if you...

  • Undergoing coronary angiography for reasons other than coronary artery disease (e.g., valve disease, hypertrophic obstructive cardiomyopathy)
  • Severe kidney dysfunction with glomerular filtration rate below 30 ml/min
  • Contraindications to adenosine, including asthma, certain heart conduction blocks without pacemaker, low blood pressure under 90 mm Hg, recent use of dipyridamole or similar drugs, or allergies to adenosine
  • Pregnant, breastfeeding, or parturient women
  • Persons unable to give informed consent or under legal protection measures
  • Participation in another clinical trial currently
  • Under administrative or judicial supervision

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Treatment

Duration - Up to 1 year

Participants undergo personalized treatment adaptation based on coronary microvascular function measured by the index of microcirculatory resistance (IMR). Those with IMR ≥ 25 receive intensified treatment, while those with IMR < 25 receive de-escalation treatment. The control group receives standard medical treatment without knowledge of IMR results.

Visits at 6 months and 1 year for assessment

Trial Site Locations

Total: 1 location

1

CHU Grenoble Alpes

La Tronche, France, 38700

Actively Recruiting

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Research Team

G

Gilles Barone Rochette

C

Clémence Charlon

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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