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Relationship between invasive physiological assessment with FFR and IMR and biological markers as micro-RNA's according to coronary vascular compartiment affected (Group 1: Macrovasculature + / Microvasculature +; Group 2: Macrovasculature + / Microvasculature -; Group 3: Macrovasculature - / Microvasculature +; Group 4: Macrovasculature - / Microvasculature -). Also, biological markers will be related with presence of microvascular spasm or macrovascular spasm (Group 5).
Patients with chest pain suggestive of angina after ruling out other cardiac and non-cardiac causes, referred for invasive coronary angiography, will be evaluated by coronary angiography and invasive coronary physiological assessment by determining FFR and IMR and by performing a vasoreactivity test with acetylcholine.
A relationship will be established between the invasive physiological assessment with FFR and IMR and biological markers such as micro-RNA's according to the affected coronary vascular compartment (Group 1: Macrovasculature + / Microvasculature +; Group 2: Macrovasculature + / Microvasculature -; Group 3 : Macrovasculature - / Microvasculature +; Group 4: Macrovasculature - / Microvasculature -). In addition, the biological markers will be related to the presence of microvascular spasm or macrovascular spasm (Group 5).
Finally, among other biological markers, the following miRNAs will be compared. These miRNA's present consistent data in the literature about their over or underexpression.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 | Macrovasculature + (FFR ≤ 0.80) / Microvasculature + (IMR ≥25) |
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| Group 2 | Macrovasculature + (FFR ≤ 0.80) / Microvasculature - (IMR <25) |
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| Group 3 | Macrovasculature - (FFR>0.80) / Microvasculature + (IMR ≥25) |
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| Group 4 | Macrovasculature - (FFR>0.80) / Microvasculature - (IMR <25) |
| |
| Group 5 | Microvascular spasm (<90% diameter contraction, Chest pain, ECG changes) or Macrovascular spasm (>90% diameter contraction, Chest pain, ECG changes) *Only patients in groups 3 and 4 will undergo the acetylcholine test. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Physiological invasive coronary evaluation | Diagnostic Test | Performance of FFR, IMR and acetylcholine test (Only patients in groups 3 and 4 will undergo the acetylcholine test) |
|
| Measure | Description | Time Frame |
|---|---|---|
| FFR | Fractional flow reserve | Intraprocedure |
| IMR | Index of microvascular resistance | Intraprocedure |
| Ach | Acetilcholine test | Intraprocedure |
| Measure | Description | Time Frame |
|---|---|---|
| QCA | Quantitative Coronary Angiography | Intraprocedure |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with angor pectoris referred for coronary angiography after excluding other cardiaca and non-cardiac causes of chest pain
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Diego Fernández-Rodriguez, MD, PhD | Contact | +34-651369729 | dfernandez.lleida.ics@gencat.cat |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Arnau de Vilanova | Recruiting | Lleida | Catalonia | 25198 | Spain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42209331 | Derived | Matute-Blanco L, Sanchez-Rodriguez M, Casanova-Sandoval J, Garcia-Guimaraes M, Rivera K, Fuertes-Ferre G, Guerrero AP, Segovia RM, Belmonte T, Benitez ID, Molinero M, Barbe F, Worner F, Bardaji A, Fernandez-Rodriguez D, de Gonzalo-Calvo D. Plasma miR-502-5p and coronary artery vasospasm: An exploratory study. Clin Investig Arterioscler. 2026 May 28:500947. doi: 10.1016/j.arteri.2026.500947. Online ahead of print. English, Spanish. |
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No specific time frame
Each center will fill an anonymized and predefined case report form (CRF) developed by the investigators. The selected variables are oriented to the cardiovascular risk factors, comorbidities, clinical findings, ischemia detection tests, medications, analytical parameters, echocardiographic and angiographic findings, and invasive physiological indexes. All data collected during the study, after deidentification, will be shared. Data obtained through this study may be provided to qualified researchers with academic interest in cardiovascular diseases. Approval of the request and execution of all applicable agreements are prerequisites for the sharing of data with the requesting party.
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| ID | Term |
|---|---|
| D000787 | Angina Pectoris |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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| D002637 |
| Chest Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |