[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100631250":3},{"organization":4,"armGroups":7,"interventions":19,"overallOfficials":32,"centralContacts":42,"locations":51,"responsibleParty":85,"collaborators":47,"id":87,"slug":88,"hasResults":89,"nctId":90,"briefTitle":91,"officialTitle":92,"acronym":93,"eligibilityCriteria":94,"healthyVolunteers":89,"sex":95,"minAge":96,"maxAge":97,"enrollmentInfo":98,"targetDuration":47,"studyType":101,"phases":102,"briefSummary":104,"conditions":105,"keywords":113,"overallStatus":54,"whyStopped":47,"lastUpdateSubmitDate":121,"lastUpdatePostDateStruct":122,"startDateStruct":125,"completionDateStruct":127,"leadSponsor":129,"locationsCount":130},{"fullName":5,"class":6},"Medical University of Bialystok","OTHER",[8,14],{"label":9,"type":10,"description":11,"interventionNames":12},"Endotype-Guided Treatment Group","EXPERIMENTAL","Participants undergo invasive and non-invasive assessment of coronary microvascular function to determine the INOCA endotype. The invasive assessment includes intracoronary acetylcholine provocation testing followed by guidewire-based measurement of coronary flow reserve and index of microvascular resistance during pharmacologically induced hyperemia. Non-invasive assessment includes echocardiographic coronary flow velocity reserve measurement in the left anterior descending artery.\n\nBased on the identified endotype of coronary microvascular dysfunction, participants receive guideline-directed pharmacotherapy targeted to the underlying mechanism in accordance with contemporary European Society of Cardiology recommendations. Follow-up assessments include quality-of-life questionnaires, functional capacity testing, and laboratory evaluation.",[13],"Diagnostic Test: Coronary microvascular function assessment",{"label":15,"type":16,"description":17,"interventionNames":18},"Standard Care Group","ACTIVE_COMPARATOR","Participants undergo the same invasive and non-invasive assessment of coronary microvascular function. Pharmacotherapy is determined by the treating physician according to standard clinical practice, without protocol-mandated endotype-guided treatment selection.",[13],[20,27],{"type":21,"name":22,"description":23,"armGroupLabels":24,"otherNames":25},"DIAGNOSTIC_TEST","Coronary microvascular function assessment","Comprehensive invasive and non-invasive evaluation of coronary microvascular function used to determine microvascular dysfunction endotype and guide treatment selection.",[9],[26],"Endotype-guided management",{"type":21,"name":22,"description":28,"armGroupLabels":29,"otherNames":30},"Comprehensive invasive and non-invasive evaluation of coronary microvascular function used to determine microvascular dysfunction endotype without endotype-guided management.",[15],[31],"Physician-guided standard care",[33,36,39],{"name":34,"affiliation":5,"role":35},"Sławomir Dobrzycki, MD, PhD","PRINCIPAL_INVESTIGATOR",{"name":37,"affiliation":5,"role":38},"Maciej A. Południewski, MD, PhD","STUDY_CHAIR",{"name":40,"affiliation":41,"role":38},"Emil J. Dąbrowski, MD, PhD","Medical University of Białystok",[43,49],{"name":44,"role":45,"phone":46,"phoneExt":47,"email":48},"Maciej A. Poludniewski, MD, PhD","CONTACT","+48 85-831-84-96",null,"maciej.poludniewski@umb.edu.pl",{"name":40,"role":45,"phone":46,"phoneExt":47,"email":50},"emil.dabrowski@umb.edu.pl",[52],{"facility":53,"status":54,"city":55,"state":47,"zip":56,"country":57,"countryCode":58,"cosmosGeoPoint":59,"geoPoint":64,"contacts":65},"University Clinical Hospital, Department of Invasive Cardiology, Internal Medicine with CICU and Catheterization Laboratory-Uniwersytecki Szpital Kliniczny w Białymstoku, Klinika Kardiologii Inwazyjnej, Chorób Wewnętrznych z OIOK i Pracownią Hemodynamiki","RECRUITING","Bialystok","15-276","Poland","PL",{"type":60,"coordinates":61},"Point",[62,63],23.16433,53.13333,{"lat":63,"lon":62},[66,68,69,70,71,74,76,78,80,82,84],{"name":44,"role":45,"phone":67,"phoneExt":47,"email":48},"+48 85 831 84 96",{"name":40,"role":45,"phone":67,"phoneExt":47,"email":50},{"name":37,"role":35,"phone":47,"phoneExt":47,"email":47},{"name":40,"role":35,"phone":47,"phoneExt":47,"email":47},{"name":72,"role":73,"phone":47,"phoneExt":47,"email":47},"Piotr Pogorzelski, MD","SUB_INVESTIGATOR",{"name":75,"role":73,"phone":47,"phoneExt":47,"email":47},"Michał Święczkowski, MD",{"name":77,"role":73,"phone":47,"phoneExt":47,"email":47},"Michał Łuczaj, MD",{"name":79,"role":73,"phone":47,"phoneExt":47,"email":47},"Maciejczyk, MD, PhD",{"name":81,"role":73,"phone":47,"phoneExt":47,"email":47},"Marcin Kożuch, MD, PhD",{"name":83,"role":73,"phone":47,"phoneExt":47,"email":47},"Oliwia Grunwald, MD",{"name":34,"role":35,"phone":47,"phoneExt":47,"email":47},{"type":86,"investigatorFullName":47,"investigatorTitle":47,"investigatorAffiliation":47,"oldNameTitle":47,"oldOrganization":47},"SPONSOR","100631250","coronoary-microcirculation-analysis-network-100631250",false,"NCT07498231","COronoary Microcirculation Analysis NETwork","Assessment of Risk Factors for Coronary Circulatory and Microcirculatory Disorders, Comparison of Invasive and Non-Invasive Diagnostic Methods, and Evaluation of the Impact of Individualized Pharmacotherapy Optimization on Patients' Quality of Life","COMA-NET","Inclusion Criteria:\n\na. Chronic coronary syndrome c. Anginal symptoms \\> CCS class I or angina equivalent d. Myocardial ischemia confirmed by non-invasive testing e. Provision of informed consent to participate in the study\n\nExclusion Criteria:\n\n1. Angiographically significant coronary artery stenosis or FFR \\\u003C 0.8\n2. Renal insufficiency with eGFR \\\u003C 30 ml\u002Fmin\u002F1.73 m²\n3. Left ventricular ejection fraction \\\u003C 40%\n4. Hypertrophic cardiomyopathy\n5. Acute coronary syndrome within \\\u003C 90 days\n6. Percutaneous coronary intervention (PCI) within \\\u003C 90 days\n7. Previous coronary artery bypass grafting (CABG)\n8. Anemia \\\u003C 10 g\u002FdL or thrombocytopenia \\\u003C 100,000\u002FµL\n9. Intraventricular conduction disturbances preventing ST-T segment assessment\n10. Severe concomitant valvular heart disease\n11. Active malignancy\n12. Type 1 diabetes mellitus\n13. Coronary artery anatomical abnormalities precluding assessment using PressureWire X (myocardial bridge causing \\> 50% luminal narrowing of the investigated vessel, severe coronary tortuosity, inability to properly cannulate coronary ostia)\n14. Pregnancy\n15. Heart failure ≥ NYHA class III\n16. Asthma or COPD with severe irreversible airflow obstruction\n17. Atrial fibrillation\n18. Second- or third-degree atrioventricular block without pacemaker implantation (IPG)\n19. Manifest pre-excitation on ECG or history of AVRT episodes without prior ablation of the accessory pathway","ALL","18 Years","75 Years",{"count":99,"type":100},180,"ESTIMATED","INTERVENTIONAL",[103],"NA","COMA.NET (Coronary Microcirculation Analysis Network) is a prospective, randomized, open-label, parallel-group clinical trial designed to determine whether endotype-guided pharmacotherapy is superior to standard care in improving quality of life in patients with ischemia with non-obstructive coronary arteries. Approximately 180-190 participants with objective ischemia will be randomized to either the control or the intervention group.\n\nPharmacotherapy based on the endotype established during intracoronary assessment will be introduced in the intervention arm of the study. The primary endpoint is the change in the Seattle Angina Questionnaire (SAQ) score from baseline to 3 months. Secondary endpoints include the diagnostic accuracy of transthoracic echocardiographic coronary flow velocity reserve (CFVR), the incidence of adverse events, associations between biomarkers and coronary microvascular dysfunction (CMD), and the identification of risk factors for specific CMD endotypes.\n\nParticipants will undergo invasive functional evaluation of the coronary microcirculation, measurement of echocardiographic CFVR, and analysis of selected circulating biomarkers. The study cohort will be followed up at three and six months and will include reassessment of quality of life (Seattle Angina Questionnaire, EuroQol 5-Dimensions 5-Level questionnaire, 12-item Short Form Health Survey), anxiety (Generalized Anxiety Disorder-7 score), and functional status (6-minute walk test).\n\nThe study began in October 2025. Primary completion is anticipated in October 2027, and the overall study completion date is expected in March 2028.",[106,107,108,109,110,111,112],"Coronary Artery Disease","Microcirculation Resistance","Microcirculation; Biomarkers; Myocardial Ischemia","Microcirculatory Dysfunction","Microcirculatory Status","Echocardiography","Doppler Echocardiography",[114,115,116,117,118,119,120],"coma.net","coma-net","coronary microcirculation","ANOCA","INOCA","angina with non-obstructive coronary arteries","ischemia with non-obstructive coronary arteries","2026-04-02",{"date":123,"type":124},"2026-04-08","ACTUAL",{"date":126,"type":124},"2025-10-10",{"date":128,"type":100},"2028-03",{"name":5,"class":6},1]