| Title |
Stratified Medical Therapy Using Invasive Coronary Function Testing in Angina The CorMicA Trial
|
|---|---|
| Published in |
JACC, September 2018
|
| DOI | 10.1016/j.jacc.2018.09.006 |
| Pubmed ID | |
| Authors |
Thomas J Ford, Bethany Stanley, Richard Good, Paul Rocchiccioli, Margaret McEntegart, Stuart Watkins, Hany Eteiba, Aadil Shaukat, Mitchell Lindsay, Keith Robertson, Stuart Hood, Ross McGeoch, Robert McDade, Eric Yii, Novalia Sidik, Peter McCartney, David Corcoran, Damien Collison, Christopher Rush, Alex McConnachie, Rhian M Touyz, Keith G Oldroyd, Colin Berry |
| Abstract |
Angina without obstructive epicardial coronary artery disease (CAD) is a common problem with distinct underlying causes. To test the hypothesis that stratified medical therapy guided by an interventional diagnostic procedure (IDP) improves patient outcomes. We conducted a randomized, controlled, blinded clinical trial of stratified medical therapy versus standard care in patients with angina. We recruited patients with angina undergoing invasive coronary angiography (standard care). Patients without obstructive CAD were immediately randomized 1:1 to the intervention group (stratified medical therapy) or the control group (standard care, IDP sham procedure). Vasoreactivity testing was performed by infusing incremental concentrations of acetylcholine (ACh) followed by a bolus vasospasm provocation (<100μg). The primary endpoint was the mean difference in angina severity at 6 months (assessed by the Seattle Angina Questionnaire summary score). 391 patients were enrolled between 25/11/2016-11/12/2017. Coronary angiography revealed obstructive disease in 206 (53.7%). 151 (39%) patients without angiographically obstructive CAD were randomized (n = 76 intervention group; n=75 blinded-control group). The intervention resulted in a mean improvement of 11.7 units in the SAQSS at 6 months (95%CI: 5.0-18.4; p = 0.001). In addition, the intervention led to improvements in the mean quality of life score (EQ5D index 0.10 units; 0.01-0.18; p = 0.024) and visual analogue score (14.5 units; 7.8-21.3; p <0.001). There were no differences in major adverse cardiac events (MACE) at the 6 month follow up (2.6% controls v 2.6% intervention; p =1.00). Coronary angiography often fails to identify patients with vasospastic and/or microvascular angina. Stratified medical therapy, including an IDP with linked medical therapy, is routinely feasible and improves angina in patients with no obstructive CAD. |
X Demographics
The data shown below were collected from the profiles of 159 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 34 | 21% |
| United Kingdom | 31 | 19% |
| Australia | 4 | 3% |
| Mexico | 4 | 3% |
| Spain | 4 | 3% |
| Saudi Arabia | 3 | 2% |
| Argentina | 3 | 2% |
| Pakistan | 3 | 2% |
| United Arab Emirates | 2 | 1% |
| Other | 25 | 16% |
| Unknown | 46 | 29% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 98 | 62% |
| Scientists | 30 | 19% |
| Practitioners (doctors, other healthcare professionals) | 21 | 13% |
| Science communicators (journalists, bloggers, editors) | 10 | 6% |
Mendeley readers
The data shown below were compiled from readership statistics for 324 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 324 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 44 | 14% |
| Other | 39 | 12% |
| Student > Bachelor | 30 | 9% |
| Student > Postgraduate | 25 | 8% |
| Student > Ph. D. Student | 23 | 7% |
| Other | 51 | 16% |
| Unknown | 112 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 148 | 46% |
| Nursing and Health Professions | 10 | 3% |
| Engineering | 9 | 3% |
| Biochemistry, Genetics and Molecular Biology | 6 | 2% |
| Psychology | 4 | 1% |
| Other | 20 | 6% |
| Unknown | 127 | 39% |
Attention Score in Context
This research output has an Altmetric Attention Score of 164. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 March 2024.
All research outputs
#252,295
of 25,728,350 outputs
Outputs from JACC
#572
of 16,931 outputs
Outputs of similar age
#5,063
of 351,984 outputs
Outputs of similar age from JACC
#23
of 240 outputs
Altmetric has tracked 25,728,350 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 16,931 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 30.1. This one has done particularly well, scoring higher than 96% of its peers.
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We're also able to compare this research output to 240 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 90% of its contemporaries.