Coronary disease & ACSRandomised controlled trial
Endotyping-informed therapy for patients with chest pain and no obstructive coronary artery disease: a randomized trial
- Randomised controlled trial
- prospective
- multicentre
- parallel group
- superiority
Authors' conclusion
In this study of patients with chest pain and unobstructed coronary arteries, endotyping-informed therapy revised the diagnosis in more than half of the participants and improved angina and health-related quality of life.
Study context
- Population
- Patients with chest pain and unobstructed coronary arteries after invasive coronary angiography
- Participants
- 250 patients
- Comparison
- Adenosine stress CMR-guided management vs control
- Primary endpoint
- Seattle Angina Questionnaire (SAQ) summary score
- Follow-up
- 12 months after randomization
Primary result
As reported in the abstract
12 months
Adjusted mean difference
20.9
95% CI 15.8–26.0
By group
Intervention
70.9
mean · SD 23.6
Control
52.1
mean · SD 24.1
Intervention vs Control
adjusted mean difference 20.9 (95% CI 15.8–26.0)
Secondary outcomes
Reclassification of initial angiogram-based diagnosis (diagnostic study primary outcome)
- Diagnosis reclassified, 131 patients
- 53.0% (95% CI 46.6-59.3%); P < 0.001
- diagnostic study primary outcome met
EQ-5D-5L (prespecified secondary) · 12 months
- Adjusted mean difference, intervention vs control
- 0.09 (95% CI 0.04-0.13)
Original publication
Endotyping-informed therapy for patients with chest pain and no obstructive coronary artery disease: a randomized trial. Nat Med. Published 10 November 2025. doi:10.1038/s41591-025-04044-4
Summarised from the published abstract; every number is checked against it