Invasive Endotyping in Patients With Angina and No Obstructive Coronary Artery Disease: A Randomized Controlled Trial
Primary result · Diagnosis of coronary vasomotor disorder after randomisationResult — go to the resultOdds ratio 4.05 95% CI 2.32–7.24Authors' conclusion
For patients with angina and no obstructive coronary arteries, a diagnosis informed by invasive functional assessment had no effect on long-term angina burden, whereas treatment satisfaction improved.
Study context
- Population
- Outpatients with angina and unobstructed coronary arteries on coronary CT angiography250 underwent endotyping
- Participants
- 231 outpatients
- Comparison
- Intervention vs Control
- Primary endpoint
- Between-group difference in reclassification rate of initial diagnosis (coronary CT angiography) vs final diagnosis after invasive endotyping
Methodological details3 UK hospitals, control blinded, Median follow-up 19.9 [12.6-26.9] months
- 3 UK hospitals
- Control blinded
- Median follow-up 19.9 [12.6-26.9] months
Primary result
As reported in the abstract
Diagnosis of coronary vasomotor disorder after randomisation
Odds ratio
4.05
95% CI 2.32–7.24
P < 0.001
By group
Intervention
76.5%
Control
- Before randomisation
- 55 (47.4%)
- Normal coronary function after randomisation
- 50.9%
Intervention vs Control
OR 4.05 (95% CI 2.32–7.24); P < 0.001
Secondary outcomes
| Outcome | Intervention | Control | P value |
|---|---|---|---|
| Seattle Angina Questionnaire summary score · 6 and 12 monthsGlobal P; not different | P = 0.36 | ||
| 6 months | 59.2±24.2 (2.3±16.2 change) | 60.4±23.9 (4.6±16.4 change) | |
| 12 months | 63.7±23.5 (4.7±14.7 change) | 66.0±19.3 (7.9±17.1 change) | |
| Global treatment satisfaction · 12 months | 69.9 ± 22.8 | 61.7 ± 26.9 | P = 0.013 |
Endotypes among patients undergoing invasive endotyping (n=250)
- Obstructive coronary disease
- 19 (7.6%)
- Microvascular angina
- 127 (55.0%)
- Vasospastic angina
- 27 (11.7%)
- Both
- 17 (7.4%)
- No abnormality
- 60 (26.0%)
Original publication
Invasive Endotyping in Patients With Angina and No Obstructive Coronary Artery Disease: A Randomized Controlled Trial. Circulation. Published 5 October 2023. doi:10.
Summarised from the published abstract; every number is checked against it