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Standardizing the Management of Patients with Coronary Microvascular Dysfunction

Not Applicable
Active, not recruiting
Conditions
Coronary Artery Disease
Microvascular Angina
Microvascular Ischemia of Myocardium
Registration Number
NCT06025994
Lead Sponsor
Consorzio Futuro in Ricerca
Brief Summary

The SAMCRO is an all comers, prospective, randomized, multicenter, open-label study with blinded adjudicated evaluation of outcomes (PROBE). The diagnosis of angina in non obstructive coronary artery disease (ANOCA) will be confirmed with coronary artery angiography and with the invasive assessment of coronary microvascular dysfunction (CMD) and coronary vasomotion. At least 120 ANOCA patients with invasively confirmed CMD will be randomized to i) multi-domain lifestyle intervention (experimental arm) vs. ii) standard of care (control arm). All patients will undergo follow-up visits at 6, 12, 24, 36, 48 and 60 months. The study endpoints will be the improvement of angina status and quality of life as assessed by validated questionnaires at one year. All participants in the multi-domain lifestyle group will receive five different kinds of intervention: i) dietary counselling, ii) strict management of cardiovascular (CV) and metabolic risk factors, iii) tailoring of medical therapy on the basis of the invasive assessment of CMD and coronary vasomotion, iv) exercise training and v) psychological intervention. Patients randomized to the control group will be managed according to current guidelines. The angina status will be assessed by the Seattle Angina Questionnaire (SAQ). Quality of life will be assessed using the EuroQoL (EQ5D-5L). Anxiety and depression will be assessed using the Beck Depression Inventory (BDI).

Detailed Description

The aim of the SAMCRO trial is to determine whether a multidomain lifestyle intervention improves angina status and quality of life in ANOCA patients as compared to current standard of care.

Patients will be randomized to:

EXPERIMENTAL ARM: MULTI-DOMAIN LIFESTILE INTERVENTION

Patients will receive five different kinds of intervention:

i) strict management of CV and metabolic risk factors, ii) tailoring of medical therapy on the basis of the invasive assessment of CMD and coronary vasomotion, iii) dietary counselling, iv) exercise training v) psychological counselling CONTROL ARM: STANDARD OF CARE Patients randomized to the control group will be managed according to current guidelines

Recruitment & Eligibility

Status
ACTIVE_NOT_RECRUITING
Sex
All
Target Recruitment
123
Inclusion Criteria
  • Patient admitted to hospital for chronic coronary syndrome (CCS) with indication for coronary artery angiography
  • absence of obstructive coronary artery disease at invasive coronary artery angiography
  • Coronary microvascular dysfunction as identified by invasive coronary physiology
Exclusion Criteria
  • Planned coronary revascularization
  • Co-morbidity reducing life expectancy to less than 1 year
  • Any factor precluding 1-year follow-up
  • Prior Coronary Artery Bypass Graft (CABG) surgery
  • Presence of a chronic total occlusion (CTO)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Seattle Angina Questionnaire1-year

The primary efficacy endpoint is the value of Seattle Angina Questionnaire (SAQ) summary score. The SAQ-SS ranges from 0 to 100 and higher values indicate better outcome

Secondary Outcome Measures
NameTimeMethod
Clinical adverse events1-year

Cumulative occurrence of death, and hospital admission for any cause

Beck Depression Inventory (BDI)1-year

The continuous value of Beck Depression Inventory (BDI). BDI score ranges from 0 to 63. Higher scores indicate greater depressive severity.

EQ visual analogue scale1-year

The continuous value of EQ visual analogue scale (EQ-VAS). The EQ-VAS scale ranges from 0 to 100 and higher values indicate better outcome

Trial Locations

Locations (2)

AOU Ferrara

🇮🇹

Ferrara, Italy

AOU di Parma

🇮🇹

Parma, Italy

AOU Ferrara
🇮🇹Ferrara, Italy

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