Testing Sodium-glucose Cotransporter 2 Inhibitors to Improve Coronary Microvascular Disease and Angina in Women Without Obstructive Coronary Artery Disease

What this Trial Is About

Researchers are evaluating the effects of Sodium-glucose cotransporter 2 inhibitors SGLT2i on coronary microvascular disease CMD and anginal symptoms in women with non-obstructive coronary artery disease ANOCA. The study aims to test whether SGLT2i treatment improves coronary microvascular function, angina symptoms, quality of life, and reduces inflammation pathways in this population. This trial addresses an urgent need for therapies targeting CMD, which is more common in women with ischemic heart disease but less recognized and treated. Participants will be randomly assigned to receive either Brezavvy 20mg oral tablets or placebo for 12 weeks. The study is a single-center, randomized, double-blind, placebo-controlled phase 1 trial. Participants will undergo stress cardiac magnetic resonance imaging CMR and coronary flow reserve CFR measurements at baseline and after 12 weeks of treatment. Blood samples will be collected at baseline, 6 weeks, and 12 weeks to evaluate inflammation markers. Quality of life will be assessed through a series of questionnaires at baseline, 6 weeks, and 12 weeks. During the study, women with angina symptoms and CMD will have two stress CMR scans to measure changes in coronary blood flow. They will complete several health and symptom questionnaires and provide blood samples at three different times to monitor inflammation and cardiac function. Researchers will measure the primary outcome of change in coronary flow reserve from enrollment to 12 weeks. Safety and adherence will be monitored throughout the trial, which lasts about three months for each participant.

Study Targeting Myocardial Perfusion and Symptom Relief in Women With SGLT2 Inhibitors (STRONG)