Study to Measure Angina Thresholds in Patients with Two Coronary Artery Narrowings Using Invasive Heart Tests and Exercise

What this Trial Is About

Researchers are investigating how different coronary artery narrowings stenoses affect the threshold at which angina symptoms begin during exercise. This study focuses on patients with stable angina who have two coronary stenoses suitable for treatment by percutaneous coronary intervention PCI. The goal is to measure the specific blood flow reductions that trigger angina symptoms at each stenosis using invasive physiological techniques. Participants will undergo PCI to treat their coronary stenoses. After stenting, a special balloon will be gradually inflated inside each stent while the participant exercises on a supine ergometer. This process will help determine the angina threshold by measuring blood flow and pressure changes in real time. The order of assessing each stent will be randomized, and the balloon inflation will stop once the participant experiences angina symptoms. These assessments will happen during the same procedure. During the study, participants will have invasive pressure measurements taken with a pressure wire during balloon inflation. Additional assessments include imaging tests such as computed tomography coronary angiography CTCA, quantitative coronary angiography QCA, intravascular imaging, and stress perfusion cardiac magnetic resonance imaging CMR. Researchers will also correlate angina thresholds with symptoms, quality of life, and pain perception. The primary outcome is the difference in angina thresholds measured by fractional flow reserve FFR and non-hyperemic pressure ratio NHPR during the procedure. The total study duration extends until December 2028.

Study of Lesion-Specific Invasive Haemodynamic Angina Thresholds