CORonary MICrovascular Angina (CorMicA)
Research type
Research Study
Full title
CORonary MICrovascular Angina (CorMicA): a randomised, controlled, pilot trial.
IRAS ID
202330
Contact name
Colin Berry
Contact email
Sponsor organisation
Golden Jubilee Foundation
Clinicaltrials.gov Identifier
Duration of Study in the UK
20 years, 0 months, 0 days
Research summary
Angina pectoris is chest pain of cardiac origin. Angina involves a lack of oxygen supply (i.e. ischaemia) and typically occurs after activity or stress. This is a common problem with over 20,000 new cases of angina occurring in the UK every year. The classic cause of angina is limitation of blood flow to the heart muscle because of a blockage in a main artery. The reference diagnostic test for angina is a coronary angiogram which can reveal blockages in the arteries. Many patients with suspected angina do not have blockages on an angiogram. They may have angina due to problems with the smaller arteries that supply heart muscle, and these blood vessels are generally too small to be seen by the angiogram. A non-cardiac cause is another possibility e.g. dyspepsia. The term "coronary microvascular angina" (CMA) refers to patients with inadequate blood supply from the tiny blood vessels to the heart muscle. CMA is a problem of unmet clinical need - not only is CMA associated with poor outcomes, but cardiology research has overlooked this area such that we do not have a good understanding of why it arises. This uncertainty is highlighted by large gaps in the evidence linking the diagnostic tests with treatment. Furthermore, routine invasive testing for this condition is not often performed so patients are are often left without further testing or therapy.
We will assess an improved diagnostic approach with tests of coronary function to rule-in or rule out CMA and assess whether this approach is feasible, changes treatment & improves health economic outcomes. The aim of the pilot study is to act as a rehearsal for a larger trial. Patients will be invited to participate in optional sub-studies for MRI and a skin biopsy to isolate and study small blood vessel function.
REC name
West of Scotland REC 1
REC reference
16/WS/0192
Date of REC Opinion
1 Nov 2016
REC opinion
Further Information Favourable Opinion