Coronary Artery Function, Myocardial Perfusion & Prognosis (COR-MED).

  • Research type

    Research Study

  • Full title

    A natural history study of coronary function in medically managed patients (COR-MED).

  • IRAS ID

    197860

  • Contact name

    Colin Berry

  • Contact email

    colin.berry@glasgow.ac.uk

  • Sponsor organisation

    Golden Jubilee National Hospital / National Waiting Times Board

  • Duration of Study in the UK

    19 years, 11 months, 30 days

  • Research summary

    Abnormalities of coronary artery function and blood flow within the heart cause symptoms of angina and are associated with an adverse prognosis. The associations between coronary function and myocardial perfusion are uncertain. Coronary artery disease (CAD) may limit coronary blood flow and myocardial perfusion, and both are important for longer term health and wellbeing.
    The causes and clinical significance of abnormalities in function of the blood vessels in the heart, and their relationships with heart muscle blood flow, function and pathology are incompletely understood. This study aims to investigate the inter-relationships and comparative prognostic significance of coronary function and myocardial perfusion as revealed by stress perfusion MRI in medically-managed patients with known or suspected angina symptoms.
    The standard care assessment of angina involves an invasive coronary angiogram and tests of the functional significance of CAD (e.g. fractional flow reserve). In patients with suspected coronary spasm and/or microvascular disease, coronary reactivity testing may also be performed (e.g. CFR, IMR, % diameter change to intra-coronary acetylcholine). These tests may be undertaken during usual clinical care, but the clinical significance is uncertain.

    The rationale for this cohort study is to prospectively enrol patients in whom tests of coronary function have been performed during invasive coronary angiography as part of standard care. Following informed consent, participants will be invited to provide a blood sample, have health status assessed with questionnaires, and have stress perfusion cardiac MRI within 30 days of the angiogram. At 12 months, the blood test and questionnaire would be repeated. Health outcomes would be assessed at 12 months. We anticipate 100 - 240 patients may be enrolled per annum. The max. sample size is 2400 and the study duration is 10 years. Informed consent will be obtained for record linkage to assess data on health status, medication and survival in the longer term.

  • REC name

    West of Scotland REC 4

  • REC reference

    16/WS/0091

  • Date of REC Opinion

    11 May 2016

  • REC opinion

    Favourable Opinion