Evaluation of Patients With Angina in the Absence of Obstructive Coronary Artery Disease
Stanford University
Summary
Patients with angina and non-obstructive CAD are common within clinical practice, but remain a challenge with regard to diagnosis and treatment. When these patients undergo a comprehensive evaluation at the time of invasive coronary angiography, occult coronary abnormalities are frequently found. We hope to learn the overall prevalence and presentation of these occult coronary abnormalities and its long term outcome in this patient population.
Description
This is a prospective registry of patients with chest pain, chest discomfort, breathlessness who do not have a blockage in their heart artery. This condition is known as angina/ischemia and non-obstructive coronary arteries (ANOCA/INOCA). The purpose of this registry is to help us understand the prevalence, causes of these conditions, identify effective diagnostic strategy, and long term outcome in this patient population. Patients will undergo comprehensive invasive evaluation including coronary angiography, intravascular imaging, and physiologic measurements as a standard of care. Details r…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: 1. Patient referred for elective coronary angiography because of a reasonable clinical suspicion of coronary ischemia. 2. Presence of angina or an anginal equivalent (including chest, back, shoulder, arm, neck, jaw discomfort, or shortness of breath brought on by physical exertion, emotional stress, or certain times of day/month). Exclusion Criteria: 1. Asymptomatic (such as a pre-op cath) 2. Status-post heart transplant 3. Age \<18 4. Renal insufficiency (creatinine \>1.5) 5. Presence of an acute coronary syndrome (STEMI or NSTEMI), Tako-tsubo, an abnormal ejection frac…
Interventions
- Procedure30 cc blood draw
- ProcedureIntravascular ultrasound (IVUS)
- ProcedureCoronary pressure/flow wire testing
- ProcedureCoronary pressure/flow testing: Acetycholine challenge
- ProcedureProcedure: Coronary pressure/flow testing: Nitroglycerin challenge
- ProcedureProcedure: Procedure: Coronary pressure/flow testing: Adenosine challenge
Location
- Stanford University School of MedicineStanford, California