Insulin Resistance and Coronary Microvascular Dysfunction in Patients with Myocardial Ischemia and Non-obstructive Coronary Artery Disease
Azienda Ospedaliera Universitaria Integrata Verona
40 participants
Jun 24, 2024
INTERVENTIONAL
Conditions
Summary
The goal of this prospective study is to assess the correlation between coronary microvascular disfunction and insulin resistance in patients with INOCA. Patients with ANOCA and without diabetes will undergo invasive coronary microvascular assessment through coronary angiography and insulin resistance assessment through hyperinsulinemic-euglycemic clamp test. Patients enrolled in the study will be followed for a period of 2 years to monitor their clinical status.
Eligibility
Inclusion Criteria3
- Aged over 18 years.
- Cardiac chest pain with evidence of myocardial ischemia at noninvasive myocardial stress imaging and clinical indication to diagnostic coronary angiography
- Willing and able to give informed consent for participation in the study
Exclusion Criteria8
- Obstructive CAD (defined as more than 70% luminal stenosis and/or FFR ≤0.80 in 1 or more epicardial vessels).
- History of previous myocardial infarction, percutaneous revascularization or coronary-aortic bypass graft (CABG) surgery.
- Diagnosis of type II diabetes.
- BMI ≥ 35 kg/m2.
- Stage IV and V of chronic kidney disease (eGFR ≤ 30 ml/min, estimated through CKD - EPI Creatinine Equation).
- Allergy or other contraindication to iodinated contrast and/or gadolinium and/or adenosine.
- Chronic resting O2 saturation ≤ 85%.
- Pregnancy or suspected pregnancy.
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Interventions
Coronary microvascular assessment with the derivation of CFR, IMR and MRR will be performed using a standard pressure/thermodilution guidewire.
Infusion of insulin and glucose adjusting rate of glucose infusion to maintaine plasma glucose around 90 mg/dL by monitoring plasma glucose levels every 5-10 minutes
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT06597851