Heart Disease of the Small Arteries in Women and Men
Recruiting
N/AInterventional Study
Heart Disease
No Placebo Group
Every participant receives an active treatment — no one gets a placebo.
Ready to participate?
Review the details below, then apply to join this clinical trial.
At a Glance
Age
18 and older
Sex
Any
Study type
Interventional
Purpose
Treatment
Participants needed
634 (estimated)
Sponsor
Cedars-Sinai Medical Center · Other
Who this trial is looking for
This trial is looking for women and men who have chest pain and related heart symptoms. Participants will help us understand a specific type of heart disease that is often not diagnosed.
Are You a Good Fit for This Trial?
You may be able to join if
I have chest pain or abnormal heart tests.
I do not have significant blockages in my coronary arteries.
I am over 18 years old.
I can give informed consent.
You may not be able to join if
I have significant blockages in my coronary arteries.
I have had a heart attack in the last 30 days.
I have a serious heart condition that needs surgery.
I cannot give informed consent.
I have chest pain from non-heart-related issues.
I have heart failure that is severe.
I have a heart pump function of less than 40%.
Summarized in plain language from this trial's official eligibility criteria.
The full criteria are further down this page — only the research team can
confirm whether you qualify.
Think this trial could be right for you?
Answer a few quick questions to see if you may meet the eligibility requirements.
Women suffer disproportionately than men from Cardiac Syndrome X ( chest pain in the absence of flow limiting coronary artery stenosis). Coronary microvascular disease is hypothesized to mediate chest pain in this syndrome. This disorder of the small heart vessels (arterioles) compared to the large vessels (arteries) is not diagnosed during routine heart catheterization. This results in delays in …
Women suffer disproportionately than men from Cardiac Syndrome X ( chest pain in the absence of flow limiting coronary artery stenosis). Coronary microvascular disease is hypothesized to mediate chest pain in this syndrome. This disorder of the small heart vessels (arterioles) compared to the large vessels (arteries) is not diagnosed during routine heart catheterization. This results in delays in diagnosis, missed opportunities for treatment, and likely contributes to the increased death rate from coronary heart disease in women compared to men.
Current testing for small vessel disease is performed in the cardiac catheterization laboratory using specialized testing and is not performed routinely. Accordingly, women with this condition are either falsely reassured, or misdiagnosed as another non-cardiac condition. Unnecessary healthcare costs related to re-hospitalization and repeat angiography are incurred, while women are often not initiated on appropriate lifesaving treatment. We and others have demonstrated in randomized controlled trials that therapies that target the endothelium, e.g. statins, ACE inhibitors, and exercise are effective in this condition.
Majority of women with Cardiac Syndorme X go undiagnosed. Recent studies have shown significant increased health care costs, morbidity and mortality related to this disease. It is becoming more important to further characterize this group of patients and we hope to do that with our study.
Trial Locations
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Status
Eligibility Criteria
Inclusion Criteria:
1. Women and men with signs and symptoms of myocardial ischemia and angina or angina equivalent (chest pain, abnormal stress testing, abnormal noninvasive testing) or microvascular angina (MVA) which is defined as angina and ischemic ECG changes without organic obstructive steno…
Inclusion Criteria:
1. Women and men with signs and symptoms of myocardial ischemia and angina or angina equivalent (chest pain, abnormal stress testing, abnormal noninvasive testing) or microvascular angina (MVA) which is defined as angina and ischemic ECG changes without organic obstructive stenosis or epicardial spasm of the coronary arteries
2. No obstructive coronary artery disease performed within the previous 24 months (\<50% luminal obstruction in one or more coronary arteries on angiography).
3. Age \> 18 years old
4. Competent to give informed consent
Exclusion Criteria:
1. Obstructive CAD ≥ 50% luminal diameter stenosis in ≥ 1 epicardial coronary artery,
2. Acute coronary syndrome (defined by the ACC/AHA criteria, Braunwald 2000),
3. Primary valvular heart disease clearly indicating the need for valve repair or replacement;
4. Patients with concurrent cardiogenic shock or requiring inotropic or intra-aortic balloon support;
5. Prior or planned percutaneous coronary intervention or CABG or prior acute MI in prior 30 days;
6. Prior non-cardiac illness with an estimated life expectancy \<4 years;
7. Unable to give informed consent;
8. Chest pain with a non-ischemic etiology (e.g.,pericarditis, pneumonia, esophageal spasm);
9. Contraindications to adenosine or Regadenoson (Lexiscan)
10. Women and men with intermediate coronary stenoses (\>20% but \<50% luminal diameter stenosis assessed visually at the time of angiography) will undergo clinically indicated IVUS testing based on the judgment of the operator; those determined to have flow FFR or obstructing stenosis will be excluded from the overall study.
11. Heart failure (NYHA Class III or IV on treatment)
12. LV dysfunction (ejection fraction \<40%)
13. Documented obstructive myocardiopathy
Contacts
Barbra Streisand Women's Heart Center
310-423-9666
CONTACT
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