Characterising disease mechanisms in patients with coronary microvascular disease

King's College London0 个研究点目标入组 74 人开始时间: 2021年1月28日最近更新: 2023年11月13日

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•1. All adult patients attending for diagnostic coronary angiography for stable angina at St. Thomas’ Hospital who are found to have unobstructed coronary arteries (epicardial coronary artery stenosis < 30% and/or pressure wire negative stenosis).
•2. Tertiary referrals for invasive microvascular assessment of patients with angina and established unobstructed coronary arteries.

•Current exclusion criteria as of 22/05/2023:
•1. Patients who are unable or unwilling to consent
•2. Contraindications to adenosine
•3. Contraindications to amlodipine and/or ranolazine
•4. Patients who are already taking the study medications for clinical reasons and are unable to stop them
•5. Presence of more than moderate valve disease
•6. Previous percutaneous coronary intervention or bypass surgery
•7. Known structural heart disease (e.g. cardiomyopathy or congenital heart disease)
•8. Pregnant or breastfeeding females
•9. Patients who are unable to exercise on a treadmill or those who can exercise for >540 seconds in the absence of any revealed cardiac symptoms on baseline exercise test
•Previous exclusion criteria:
•1. Patients who are unable or unwilling to consent
•2. Contraindications to adenosine or acetylcholine (for the catheter laboratory protocol), or amlodipine or ranolazine (for the exercise protocol)
•3. Presence of more than moderate valve disease
•4. Previous stenting or bypass surgery
•5. Heart failure with reduced ejection fraction (LVEF< 50%), cardiomyopathy or congenital heart disease
•6. Pregnant or breastfeeding females
•7. Patients who are unable to exercise on a treadmill or those who have a good exercise capacity at baseline (>540seconds in men and >480seconds in women) will be excluded from the exercise protocol

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