Coronary disease & ACSRandomised controlled trial
Invasive Endotyping in Patients With Angina and No Obstructive Coronary Artery Disease: A Randomized Controlled Trial
- Randomised controlled trial
- 3 UK hospitals
- control blinded
- Median follow-up 19.9 [12.6-26.9] months
Authors' 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
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
55 (47.4%)
Before randomisation · 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 months · global 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:10.1161/circulationaha.123.064751
Summarised from the published abstract; every number is checked against it