Efficacy of Targeted Medical Therapy in Angina and Nonobstructive Coronary Arteries

Description

The goal of this clinical trial is to learn if targeted medical therapy will improve symptoms and quality of life in patients with angina and non-obstructive coronary arteries compared to placebo, after the underlying cause of the chest pain has been ascertained by coronary function testing. Participants will be treated with either medications that target the underlying cause of their chest pain or placebo for 4 weeks after a drug titration phase of 1-3 weeks. They will be asked to complete a series of questionnaires to evaluate their quality of life at the beginning and end of the study.

Conditions

Angina Pectoris, Microvascular Angina, Vasospastic Angina, Myocardial Bridge of Coronary Artery

Study Overview

Study Details

Study overview

The goal of this clinical trial is to learn if targeted medical therapy will improve symptoms and quality of life in patients with angina and non-obstructive coronary arteries compared to placebo, after the underlying cause of the chest pain has been ascertained by coronary function testing. Participants will be treated with either medications that target the underlying cause of their chest pain or placebo for 4 weeks after a drug titration phase of 1-3 weeks. They will be asked to complete a series of questionnaires to evaluate their quality of life at the beginning and end of the study.

A Randomized Controlled Study of Targeted Medical Therapy Versus Placebo for Angina and Non- Obstructive Coronary Arteries: The MVP-ANOCA Study

Efficacy of Targeted Medical Therapy in Angina and Nonobstructive Coronary Arteries

Condition
Angina Pectoris
Intervention / Treatment

-

Contacts and Locations

Palo Alto

Stanford Hospital, Palo Alto, California, United States, 94304

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

For general information about clinical research, read Learn About Studies.

Eligibility Criteria

  • * All patients with stable angina referred to the Stanford University Hospital cardiac catheterization laboratory for clinically indicated coronary function testing are eligible for inclusion into the study.
  • * Absence of significant epicardial coronary artery disease on angiography
  • * Fractional flow reserve \> 0.80
  • * Epicardial coronary spasm on acetylcholine testing
  • * Microvascular spasm on acetylcholine testing
  • * Coronary flow reserve \< 2.5
  • * Index of microcirculatory resistance ≥ 25
  • * Myocardial bridge on intravascular ultrasound with dobutamine resting full-cycle ratio ≤ 0.76
  • * Acute coronary syndrome less than one week prior to enrolment
  • * Cardiomyopathy
  • * Contraindications to beta-blockers or calcium channel blockers
  • * Baseline systolic blood pressure \< 95 mmHg
  • * Baseline heart rate \< 55 bpm

Ages Eligible for Study

18 Years to

Sexes Eligible for Study

ALL

Accepts Healthy Volunteers

No

Collaborators and Investigators

Stanford University,

Jennifer Tremmel, MD, PRINCIPAL_INVESTIGATOR, Stanford University

Study Record Dates

2026-12