Condition: Angina With No Obstructive Coronary Artery Disease · ANOCA · Coronary Sinus Reducer · Sponsor: Medical University of Warsaw
Even half of patients with angina undergoing invasive coronary angiography presents without any significant epicardial stenosis. In these cases, symptoms are usually caused by coronary microvascular dysfunction (CMD), developing as a result of several potential underlying pathophysiologies. A wide range of underlying pathomechanisms makes it challenging to develop molecular-targeted pharmacological solutions; thus, direct physiology modification has been introduced as a promising concept. The coronary sinus reducer (CSR) narrows the coronary sinus, which causes symptom relief in patients with refractory angina and coronary stenosis. CSR implantation aims to increase the coronary sinus pressure, which raises venous back pressure into the myocardium. Despite several hypotheses, the exact physiological mechanisms remain not fully elucidated. Recent data from observational studies also suggest the beneficial effect of CMD on microvascular indices. To date, there are limited data regarding the efficacy of this solution in patients with angina with no obstructive coronary artery disease (ANOCA). Of note, patients with ANOCA are frequently burdened with other comorbidities, such as heart failure with preserved ejection fraction (HFpEF). HFpEF presence relates to worse prognosis and higher risk of future cardiovascular events. Previous works showed that HFpEF is significantly associated with the appearance of CMD. Due to the small variety of drugs for HFpEF, treatment targeting CMD m…
This description comes directly from the study's public registry record.
Mariusz Tomaniak, Professor · +48 22 5991951 · mariusz.tomaniak@wum.edu.pl
Adrian Bednarek · adrian.bednarek@wum.edu.pl
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| Medical University of Warsaw | Warsaw, Poland | Recruiting |
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Source record: clinicaltrials.gov/study/NCT07010029