Active not recruitingNAINTERVENTIONAL

Coronary Microvascular Function and CT Coronary Angiography (CorCTCA)

This study, called CorCTCA, is for people in the UK who experience angina (chest pain) but don't have blockages in their main heart arteries. Currently, it's often confusing for doctors and patients to understand the cause of this pain. We believe that problems in the tiny blood vessels of the heart, or spasms, might be the reason. The study will use special tests to check how well these smaller heart vessels are working. By comparing how doctors manage patients with and without this extra test information, we hope to learn if these tests can improve diagnosis, guide better treatment decisions, and ultimately improve the health and well-being of people with angina.

At a glance

Status

Active not recruiting

Phase

Sponsor

NHS National Waiting Times Centre Board

Enrolment target

250

Start

31 Aug 2017

Estimated completion

31 Aug 2033

Angina, Stable Angina Pectoris, Variant Microvascular Angina

What is this study about?

Imagine your heart is a house, and the main roads leading to it are clear, but you still have problems inside. This study focuses on people who have chest pain, called angina, but when doctors look at the main "roads" (their biggest heart arteries) using scans, they don't find any major blockages. This can be very confusing and frustrating for both patients and doctors because the pain is real, but the cause isn't obvious. This type of angina affects many people in the UK.

Doctors think that the problem might be with the very small blood vessels in the heart, or that these vessels might sometimes spasm. Current scans are good at seeing big blockages but not these tiny issues. This study wants to use special tests that can actually measure how well these small vessels are working. By doing this, we hope to get a clearer picture of what's causing the angina in these patients.

The main goal is to find out if giving doctors this extra information from the special tests helps them make better decisions about treatment. We will compare groups of patients: some whose doctors get the test results, and some whose doctors don't, to see if the patients whose doctors have the results end up with clearer diagnoses and feel better in the long run. This research could lead to better ways of diagnosing and treating angina for many people.

Key takeaways

This study is for people with angina where main heart arteries are clear.
It aims to understand if problems with tiny heart vessels cause this pain.
Special tests will measure how well small heart vessels are working.
The study wants to see if these tests help doctors make better treatment choices.
It could lead to improved diagnosis and care for certain types of angina.
Participation involves heart scans, special tests, and questionnaires.

Who may be eligible?

You might be able to take part in this study if you are 18 years old or older and have symptoms of angina, which is chest pain or discomfort, as identified by a special questionnaire. Importantly, scans of your heart arteries (CT coronary angiography) should show that you don't have severe blockages (more than 70% narrow) in your main heart arteries.

However, you won't be able to join if your angina can be explained by another clear health problem, such as severe anaemia or a serious heart valve issue. You also can't be in the study if your CT scan shows significant blockages (more than 70% narrow) in your main heart arteries, or if a more detailed test during angiography shows a significant problem with blood flow (a Fractional Flow Reserve value of 0.80 or less) in a larger heart artery.

The study is open to both men and women. If you are interested, a healthcare professional will go through all the criteria with you to see if it's a good fit.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

I am 18 years old or older.
I have symptoms of chest pain or discomfort (angina).
A heart scan (CT coronary angiography) has shown my main heart arteries do not have severe blockages (>70%).
I do not have another clear health problem that fully explains my angina (like severe anaemia).
I have not had a recent heart test during angiography showing a significant blood flow problem (FFR ≤0.80).

Answer every question to see your result.

What does participation involve?

If you join this study, you will first have a CT coronary angiography scan if you haven't recently had one. If that scan shows you have angina but no severe blockages, you will be invited to have a special heart procedure called an invasive angiogram (a type of heart scan that involves putting a thin tube into a blood vessel). During this procedure, the research team will perform special tests to measure how well the small blood vessels in your heart are working. Before these special tests, you will be randomly assigned to one of two groups: either your doctor will be told the results of these special tests, or they won't, to see if this information changes how they manage your care. We will record your doctor's treatment decisions both before and after this information (or lack thereof) is provided.

Throughout the study, you will be asked to complete several questionnaires. These will help us understand your health, how your angina affects your daily life, your views on your illness, how satisfied you are with your treatment, and how well you are managing activities. We will also keep track of what angina medications you are taking and how regularly you take them. The total duration of your participation will depend on the follow-up period required for the questionnaires and observation of your treatment plan.

Potential risks and benefits

Taking part in this study might offer you some benefits, such as a more detailed understanding of your angina, which could lead to more tailored treatment from your doctor. However, there's no guarantee the study will directly improve your health. As with any medical procedure, there are potential risks associated with the invasive angiogram, including a small risk of bleeding, infection, or other complications, which your doctor will discuss with you in detail. The special tests performed during the angiogram are generally safe but carry small additional risks. You are free to withdraw from the study at any time, for any reason, without it affecting your usual medical care.

Locations (3)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

Golden Jubilee National Hospital
Verified postcode
Clydebank, United Kingdom
Forth Valley Royal Hospital
Verified postcode
Larbert, United Kingdom
Glasgow Royal Infirmary
Verified postcode
Glasgow, United Kingdom

Common questions

What is angina?

Angina is a type of chest pain or discomfort you get when your heart muscle isn't getting enough oxygen-rich blood. It can feel like tightness, heaviness, or squeezing in your chest.

What does 'non-obstructive coronary artery disease' mean?

It means you have angina symptoms, but scans of your main heart arteries don't show any severe blockages that would usually explain the pain. Your main arteries are mostly clear.

What are 'coronary function tests'?

These are special tests done during a heart procedure to measure how well the smallest blood vessels in your heart are working, and if they are properly responding to the heart's needs.

Will my doctor know my test results?

You'll be randomly put into a group where your doctor either will or won't be told the results of the special tests. This helps us see if having this information changes how doctors manage care.

Do I have to take part?

No, taking part is completely voluntary. You can decide not to join, or withdraw at any time, and your medical care will not be affected.