Related Experiment Video
Updated: Jan 4, 2026
10:28
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
5.7K
1-Year Outcomes of Angina Management Guided by Invasive Coronary Function Testing (CorMicA)
Thomas J Ford1, Bethany Stanley2, Novalia Sidik3
1West of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, United Kingdom; British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom; Gosford Hospital, NSW Health, Gosford, Australia.
JACC. Cardiovascular Interventions
|November 12, 2019
Summary
Invasive coronary function testing improved angina symptoms and quality of life for patients without obstructive coronary artery disease. This stratified medical therapy approach showed sustained benefits at one year.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Procedures
Background:
- Angina management in patients without obstructive coronary artery disease (CAD) is challenging.
- Invasive coronary function testing (ICFT) offers potential for personalized medical therapy.
- Long-term outcomes of ICFT-guided management in this population remain under investigation.
Purpose of the Study:
- To evaluate the effectiveness of ICFT in stratifying management for angina patients without obstructive CAD.
- To assess the impact of ICFT-guided therapy on patient-reported outcomes and clinical events.
Main Methods:
- 151 patients with angina and ischemia but no obstructive CAD were randomized.
- Intervention group received stratified medical therapy guided by ICFT.
- Control group received standard care with blinded ICFT results.
- Primary endpoints included 1-year Seattle Angina Questionnaire and EQ-5D scores, and major adverse cardiac events.
Main Results:
- The intervention group showed a significant improvement in overall angina symptoms (27% increase in SAQ score) at 1 year (p<0.001).
- Quality of life (EQ-5D index) significantly improved in the intervention group compared to controls (mean difference 0.11 units, p=0.010).
- Major adverse cardiac events were similar between groups after a median 19-month follow-up (12% vs 11%, p=0.803).
Conclusions:
- Stratified medical therapy guided by ICFT significantly improves angina symptoms and quality of life in patients with ischemia and no obstructive CAD.
- These benefits are sustained at one year post-procedure.
- ICFT facilitates effective management strategies for this patient cohort.
Related Concept Videos
01:20Angina V: Nursing Management
266
Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
266
01:26Angina IV: Management
205
IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
205
01:27Coronary Artery Disease V: Interprofessional Care
198
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
198
01:29Angina III: Clinical Manifestations and Assessment
171
Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
171
01:28Acute Coronary Syndrome IV: Interprofessional Care
188
IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
188
01:27Angina II: Classification
252
Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
252