NHS National Waiting Times Centre Board started Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging Trial
NHS National Waiting Times Centre Board is conducting the clinical trial Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging (CorCMR) Trial (CorCMR).
Anginal symptoms due to ischaemia with no obstructive coronary arteries (INOCA) is a common clinical problem, however, diagnosis and onward management is heterogeneous, and prognosis is affected. Recent advances in quantifying myocardial blood flow using stress perfusion cardiac magnetic resonance imaging (CMR) has potential for accurate detection coronary microvascular dysfunction.
The CorCMR diagnostic study involves stress perfusion CMR in patients with suspected INOCA to clarify the prevalence of subgroups of patients with underlying problems, such as microvascular disease or undisclosed obstructive coronary artery disease, that might explain their anginal symptoms.
This trial will determine whether stratified medical therapy guided by the results of the stress perfusion CMR improves symptoms, well-being, cardiovascular risk and health and economic outcomes.
It is planned to include 280 participants.
The actual study start date is February 9, 2021. The researchers expect to complete the study by February 2024.
One primary outcome measure is Reclassification of the initial diagnosis, The reclassification of the initial diagnosis based on invasive management following multi-parametric stress perfusion CMR.
Inclusion Criteria:
- Age ≥18 years.
- Symptoms of angina or angina-equivalent informed by the Rose Angina questionnaire.
- Coronary angiography ≤3 months with a plan for medical management.
Exclusion Criteria:
- Obstructive coronary artery disease i.e. a stenosis >70% in a single segment or 50 - 70% in 2 adjacent segments in an artery >2.5 mm, or FFR ≤0.80.
- Coronary revascularization by percutaneous coronary intervention or coronary artery bypass graft surgery following the index angiogram.
- Prior coronary artery bypass surgery.
- A diagnosis that would explain the angina e.g. anaemia, aortic stenosis, hypertrophic cardiomyopathy.
- Contra-indication to contrast-enhanced CMR e.g. eGFR < 30mL/min/1.73m2.
- Contra-indication to intravenous adenosine, i.e. severe asthma; long QT syndrome; second- or third-degree AV block and sick sinus syndrome.
The location of the study is as follows (further details can be found here https://ichgcp.net/clinical-trials-registry/NCT04805814) Glasgow, United Kingdom.
