Coronary Microvascular Angina Cardiac Magnetic Resonance Imaging (CorCMR) Trial
United Kingdom280 participantsStarted 2021-02-09
Plain-language summary
Anginal symptoms due to ischaemia with no obstructive coronary arteries (INOCA) is a common clinical problem, however, diagnosis and onward management is heterogeneous, and prognosis is affected. Recent advances in quantifying myocardial blood flow using stress perfusion cardiac magnetic resonance imaging (CMR) has potential for accurate detection coronary microvascular dysfunction.
The CorCMR diagnostic study involves stress perfusion CMR in patients with suspected INOCA to clarify the prevalence of subgroups of patients with underlying problems, such as microvascular disease or undisclosed obstructive coronary artery disease, that might explain their anginal symptoms.
A nested, prospective, randomised, controlled, double-blind trial will determine whether stratified medical therapy guided by the results of the stress perfusion CMR improves symptoms, well-being, cardiovascular risk and health and economic outcomes.
Who can participate
Age range18 Years
SexALL
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Inclusion criteria
✓. Age ≥18 years
✓. Symptoms of angina or angina-equivalent informed by the Rose Angina questionnaire.
✓. Coronary angiography ≤3 months with a plan for medical management.
Exclusion criteria
✕. Obstructive coronary artery disease i.e. a stenosis \>70% in a single segment or 50 - 70% in 2 adjacent segments in an artery \>2.5 mm, or FFR ≤0.80.
✕. Coronary revascularization by percutaneous coronary intervention or coronary artery bypass graft surgery following the index angiogram.
✕. Prior coronary artery bypass surgery
✕. A diagnosis that would explain the angina e.g. anaemia, aortic stenosis, hypertrophic cardiomyopathy,
✕. Contra-indication to contrast-enhanced CMR e.g. eGFR \< 30mL/min/1.73m2.
✕. Contra-indication to intravenous adenosine, i.e. severe asthma; long QT syndrome; second- or third-degree AV block and sick sinus syndrome.