MICRO: a Registry Study in Patients With Microvascular Angina
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Assessment of microvascular function with intracoronary hemodilution.
- Who it may be relevant to
- Registry conditions: Microvascular Disease. Basic parameters: 18 years — 85 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Germany
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
A Multicenter Registry on the Diagnosis of Patients With Chronic Angina and no Angiographic Coronary Artery Stenosis
Overview
The evidence above demonstrates that microvascular dysfunction is an important determinant of patient prognosis, which however remains poorly classified. Given the high burden of disease and the severity of the functional impairment in these patients, the lack of a clear definition for this disease has a potentially large clinical importance. It is important to better describe the phenotype of these patients, identify the predictors of prognosis, and determine the impact of diagnosis.
Detailed description
The study is designed as prospective registry. Patients with angina CCS II-IV undergoing assessment of microvascular function will be enrolled.
The study does not interfere with the medical standards at the sites with regards to patient treatment or follow-up care.
Study duration and schedule The duration of this study is expected to be 7 years. The subject recruitment is planned to start in January 2020 and end in January 2022. The actual overall study duration or subject recruitment period may differ from these time periods. Per-patient, the duration of participation will be up to 5 years. Patients will be evaluated at hospital discharge, at 12 months and 5 years (the latter two as telephone contacts).
Number of subjects and study centers It is planned to enroll 1000 subjects in the registry based on power calculations as described. Recruitment and treatment of subjects is expected to be performed in 10 study centers.
Primary endpoint The primary endpoint is the composite of cardiovascular death, myocardial infarction, rehospitalization for angina or heart failure, and unplanned coronary angiography at 12 months.
Secondary endpoints Each of the components of the primary endpoint Seattle Angina Questionnaire SAQ-7 Physical limitation scale SAQ-7 angina stability scale SAQ-7 angina frequency scale SAQ-7 angina quality of life EQ-5D-5L Beck depression inventory
The SAQ-7 "angina frequency" domain has been shown to correlate to improvements in microvascular function in the WISE study. SAQ-7-7 has been also used in a number of studies, including the ISCHEMIA study.
Other patient questionnaires are also standardized tests for the assessment of quality of life, depression and symptom severity in coronary artery disease studies.
Interventions
- Device Assessment of microvascular function with intracoronary hemodilution
The pressure/temperature wire allows assessing coronary flow reserve, intracoronary pressure, and coronary flow to calculate multiple parameters of coronary macro- and microvascular function.
Primary outcome measures
- Prognostic impact of resting resistances [Time frame: 12 months]
Secondary outcome measures (6)
- Correlation between SAQ measures and IMR [Time frame: 6 months, 1 year and yearly to 5 years.]
- Correlation between depression and IMR [Time frame: 6 months, 1 year and yearly to 5 years.]
- Correlation between physical ability and IMR [Time frame: 6 months, 1 year and yearly to 5 years.]
- Distribution of mean transit time (Tmn) [Time frame: At inclusion]
- Distribution of index of microvascular resistances (IMR) [Time frame: At inclusion]
- Distribution of aortic and distal pressure [Time frame: At inclusion]
Eligibility criteria
Inclusion criteria
- Age ≥ 18 and <85 years.
- Chronic coronary syndrome (including patients with anginal equivalents)
- Angina CCS class II-IV
- Evidence of reversible ischemia on non-invasive testing
- Availability of the following measurements:
- Index of microvascular resistances (IMR),
- Resting full-cycle ratio (RFR),
- Fractional flow reserve (FFR),
- Coronary flow reserve (CFR)
- Willingness to participate and ability to understand read and signed the informed consent document before the procedure
Exclusion criteria
At least one of the following:
- Pregnancy and or lactation.
- Medical or psychological conditions that would jeopardize an adequate and orderly participation.
- Left ventricular ejection fraction lower than 30%
- Previous coronary artery bypass surgery (CABG) to all major branches in the LAD and left circumflex (LCX) territory, such that IMR cannot be measured
- Decompensated congestive heart failure (CHF)
- Chronic or acute renal failure with creatinine >2mg/dl
- Severe valvular heart disease
- Patients with comorbidities limiting life expectancy to less than one year
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Cohort
Study locations
Germany · 1 center
- Universitätsmedizin Mainz — Mainz
Identifiers
NCT: NCT04612322 · 2020-2