RecruitingNAINTERVENTIONAL

iCorMicA - Stratified Medicine in Angina

The iCorMicA study is investigating better ways to manage chest pain, known as angina, especially for people where traditional scans don't show blockages in the main arteries of the heart. This condition is often called INOCA. Researchers want to see if using a special heart test, called an interventional diagnostic procedure (IDP), to guide treatment can lead to fewer symptoms, better quality of life, and improve overall heart health. This large study will involve many hospitals and will compare personalised treatment plans with standard care. It builds on previous research that suggested this tailored approach could be very helpful for many people experiencing angina.

At a glance

Status

Recruiting

Phase

Sponsor

NHS Greater Glasgow and Clyde

Enrolment target

1,500

Start

30 Dec 2020

Estimated completion

31 Dec 2030

Microvascular Angina Angina, Stable Ischemia With No Obstructive Coronary Arteries (INOCA)Coronary Microvascular Dysfunction (CMD)Ischaemic Heart Disease Non-Obstructive Coronary Atherosclerosis Coronary Artery Disease Vasospastic Angina Coronary; Ischemic Angina Attacks

What is this study about?

The iCorMicA study is a large research project looking into a common problem: chest pain (angina) in people whose main heart arteries aren't blocked. When you have angina, it means your heart isn't getting enough blood, which often causes discomfort or tightness in your chest. Usually, doctors check for blockages in the large arteries supplying your heart. However, for a significant number of people (more than one in three), these main arteries are clear, yet they still experience angina.

This study aims to find out if taking a more personalised approach to treatment can help these individuals. Researchers will use a special heart test called an "interventional diagnostic procedure" (IDP) during a routine heart examination. The results of this test help doctors understand *why* the heart isn't getting enough blood, even without major blockages. This might be due to problems with the tiny blood vessels in the heart (microvascular angina) or spasms in the arteries (vasospastic angina). Based on these detailed test results, participants will receive tailored treatment.

The main goal is to see if this personalised treatment approach improves symptoms, makes people feel better overall, reduces future heart risks, and leads to better health outcomes compared to standard care. This study is building on promising results from an earlier pilot study, with improvements to make the findings even more robust and applicable to a wider group of people across the UK.

Key takeaways

Targets angina without major artery blockages (INOCA).
Compares standard care with personalised treatment guided by special heart tests.
Aims to improve symptoms, well-being, and long-term heart health.
Builds on previous promising research.
Involves a key test called an Interventional Diagnostic Procedure (IDP).

Who may be eligible?

To be considered for this study, you need to be at least 18 years old and have been scheduled for a procedure called an invasive coronary angiography because you're experiencing angina symptoms. Your angina symptoms might be typical or atypical, as assessed by specific health questionnaires.

There are also some reasons why you might not be able to join. For example, if your angiography is mainly for another heart condition (like valve problems or heart failure), or if you've already had heart bypass surgery. You also can't participate if your angiography reveals a significant blockage (more than 50%) in one of your main heart arteries.

Some patients who don't meet the full study criteria, such as those with minor blockages, might still be asked to be part of a follow-up registry, which helps researchers gather valuable information over time.

Quick self-check

Are you 18 years old or older?
Are you scheduled for a heart angiogram due to angina symptoms?
Have you NOT had previous heart bypass surgery?
Do you NOT have a major blockage (>50%) in your main heart arteries?

This is a guide only — the research team will confirm whether you can take part.

What does participation involve?

If you join the iCorMicA study, you'll undergo an interventional diagnostic procedure (IDP) as part of your planned heart examination. Some participants will have the results of this test used to guide their treatment plan, while others will have the test performed but their doctors won't be told the results immediately. This helps researchers compare the two approaches fairly. The study will involve regular follow-up visits to check your symptoms, well-being, and overall heart health over a period of time. You won't be asked to take any specific medication just for the study, but your existing treatments might be adjusted based on the study findings.

Potential risks and benefits

Taking part in this study may offer potential benefits, such as receiving a more tailored and potentially more effective treatment plan for your angina. This could lead to a better understanding of your condition and improved overall well-being. As with any medical procedure, there are potential risks associated with the interventional diagnostic procedure, which your medical team will discuss with you in detail. You are free to withdraw from the study at any time without affecting your medical care.

Locations (39)

Mater Private Hsopital
Cork, Ireland· Completed
Mater Private Hospital
Dublin, Ireland· Completed
Radboud University Medical Centre
Nijmegen, Netherlands· Recruiting
5th Military Hospital
Krakow, Poland· Recruiting
Golden Jubilee National Hospital
Clydebank, United Kingdom· Recruiting
Aberdeen Royal Hospital
Aberdeen, United Kingdom· Completed
William Harvey Hospital
Ashford, United Kingdom· Recruiting
Basildon University Hospital - Essex Cardiothoracic Centre
Basildon, United Kingdom· Completed
Bedford Hospital NHS Trust
Bedford, United Kingdom· Recruiting
Royal Victoria Hospital
Belfast, United Kingdom· Recruiting
Birmingham Heartlands Hospital
Birmingham, United Kingdom· Recruiting
Royal Blackburn Teaching Hospital
Blackburn, United Kingdom· Recruiting

+27 more sites — see the official record for the full list.

Common questions

What is angina?

Angina is chest pain or discomfort that happens when your heart muscle isn't getting enough oxygen-rich blood. It often feels like pressure, squeezing, or a heavy feeling in your chest.

What is INOCA?

INOCA stands for Ischemia with Non-Obstructive Coronary Arteries. This means you have angina symptoms and your heart isn't getting enough blood (ischemia), but scans don't show any major blockages in the main heart arteries.

What is an Interventional Diagnostic Procedure (IDP)?

An IDP is a special test performed during a heart catheterisation. It helps doctors understand the health of the tiny blood vessels in your heart or if there are spasms, even if larger arteries appear clear.

Will I know if I'm getting the 'personalised' treatment?

You might not immediately know if the results of your IDP are directly guiding your immediate treatment during the study. This is part of the study design to ensure fair comparison between the groups. Your medical team will always ensure you receive appropriate care.

How long will I be followed up if I join?

The study involves follow-up visits to monitor your symptoms and health. Your medical team will explain the specific duration of follow-up for the study.

How to find out more

Colin Berry, MBChB, PhD

colin.berry@glasgow.ac.uk +44 141 330 3325 Official trial record

Always speak to your GP or specialist before deciding to take part in a study.