A pilot trial to investigate whether a more thorough test for angina could lead to better treatment

CORonary MICrovascular Angina (CorMicA): A mechanistic pilot trial and nested MRI sub-study

Angina is a form of chest pain that is caused by a lack of blood supply to the heart muscle. It can be triggered when people experience stress or exertion, and is a common health problem in the UK. The diagnosis and treatment of people with suspected angina usually requires an angiogram – when a catheter is used to put dye into the coronary arteries, so that blockage or narrowing will show up on an x-ray. However, about one third of angiograms in people with suspected angina do not reveal any blockages. This might be because the narrowing is in microvessels that are too small to be seen on a standard angiogram. There are tests available that can detect this, but they are not used routinely, so people may not be getting treatments that could benefit them. In this study, Professor Colin Berry and colleagues will carry out these microvessel function tests during the usual angiogram procedure in 150 patients with chest pain. The microvessel results will be given to the patient’s cardiologist in half of cases, but not disclosed in the other half. The aim is to see if the availability of this information changes treatment decisions for the benefit of patients. If the results show that patients do benefit, the team will plan a larger study that could influence NHS practice in the future.