Trial reportJournal of the American College of Cardiology2018
Stratified Medical Therapy Using Invasive Coronary Function Testing in Angina: The CorMicA Trial.
Trial report in Journal of the American College of Cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 12 registered trials, which are not on this map. Cited by 410 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
PROgnostic Value of Precision Medicine in Patients With Myocardial Infarction and Non-obStructive Coronary artEries: the PROMISE Trial.
CORonary MICrovascular Angina (CorMicA): a Randomised, Controlled, Pilot Trial
Angina in Patients Without Obstructive Coronary Disease as Revealed by CT Coronary Angiography (Cor-CTCA): an Observational Cohort Study Involving Coronary Function Tests and a Nested Randomised Trial
International Study of Coronary Microvascular Angina (iCorMicA): a Randomised, Controlled, Multicentre Trial and Registry
The Clinical Utility Of Cardiac Magnetic Resonance Imaging in Patients With Angina But No Obstructive Coronary Disease (CorCMR): A Diagnostic Study And Nested Randomised Trial
The Effect of Mineralocorticoid Receptor Antagonist Therapy in Patients With Acute Myocardial Infection or Injury and no Obstructive Coronary Arteries: a Registry-based, Stratified-medicine, Randomized, Controlled Trial
BIOmarkers and PLAtelet Function Assessment in Myocardial Ischemia and Non Obstructive Coronary Arteries Study: The BIOplatINO Study
Intracoronary Provocative Test With Acetylcholine in Patients With Stable Myocardial Ischemia or Myocardial Infarction and Non-Obstructive Coronary Arteries: the "Provoke" Study
Coronary Microvascular Dysfunction in Chronic Coronary Syndrome - Invasive Assessment With Thermo-dilution Technique in the LAD and Biobanking in an All-comer Population
A Multi-center, Real-World Clinical Trial on Assessment of Microcirculatory Status Using Online Coronary Angiography-Derived Index of Microcirculatory Resistance (caIMR) (Flash V)
Inorganic Nitrate as a Treatment for ANOCA: NO-ANOCA
Invasive Functional and Morphological Coronary Assessment Followed by Phenotype-Guided Multidisciplinary Treatment in Women With Angina and Non-Obstructive Coronary Arteries: A Prospective Single-Center Interventional Study
Who cites it
410 citing papers in PubMed, 8 syntheses or guidelines pooled it, 735 citations in OpenAlex.
- The Relationship of Coronary Microvascular Dysfunction and Left Ventricular Systolic and Diastolic Dysfunction: A Systematic Review and Meta-Analysis.Echocardiography (Mount Kisco, N.Y.) · 2026Pooled it
- Understanding Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): a comprehensive meta-analysis of clinical characteristics, management, and prognosis compared to MI with the Obstructive Coronary Artery (MIOCA).BMC cardiovascular disorders · 2025Pooled it
- Pooled it
- A systematic review of enrolment criteria and treatment efficacy for microvascular angina.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Pooled it
- Comparative efficacy of commercial Chinese polyherbal preparation for coronary microvascular dysfunction: a systematic review and network meta-analysis of randomized controlled trials.Frontiers in pharmacology · 2025Pooled it
- Angiography-based coronary microvascular assessment with and without intracoronary pressure measurements: a systematic review.Clinical research in cardiology : official journal of the German Cardiac Society · 2024Pooled it
- The Diagnostic Value of ECG Characteristics for Vasospastic and Microvascular Angina: A Systematic Review.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2024Pooled it
- International Systematic Review of Utility Values Associated with Cardiovascular Disease and Reflections on Selecting Evidence for a UK Decision-Analytic Model.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Pooled it
- Endotype-informed therapy and effects on illness perception and psychological health in patients with chest pain and no obstructive coronary artery disease.European heart journal. Quality of care & clinical outcomes · 2026Trial
- Determining the Physiological Threshold for Angina (ORBITA-FIRE): A Double-Blind, Randomized, Placebo-Controlled Study.Circulation · 2026Trial
- Trial
- Women's IschemiA TRial to Reduce Events In Non-ObstRuctive CAD (WARRIOR): a randomised controlled trial.Open heart · 2026Trial
- Stratified treatment of myocardial infarction with non-obstructive coronary arteries: the PROMISE trial.European heart journal · 2026Trial
- Endotyping-informed therapy for patients with chest pain and no obstructive coronary artery disease: a randomized trial.Nature medicine · 2026Trial
- Coronary function testing vs angiography alone to guide treatment of angina with non-obstructive coronary arteries: the ILIAS ANOCA trial.European heart journal · 2025Trial
- Sex Differences in Psychosocial Factors and Angina in Patients With Chronic Coronary Disease.Journal of the American Heart Association · 2025Trial
- Coronary microvascular function and atherosclerotic plaque burden in ischaemia and no obstructive coronary arteries: a secondary analysis of the CorMicA trial.Heart (British Cardiac Society) · 2025Trial
- Zibotentan in Microvascular Angina: A Randomized, Placebo-Controlled, Crossover Trial.Circulation · 2024Trial
- Association between coronary vasomotor dysfunction and autoimmune disease in patients undergoing invasive coronary function testing.International journal of cardiology. Heart & vasculature · 2026Article
- Intracoronary physiological indices for coronary microvascular dysfunction: from concept to clinical application.Cardiovascular intervention and therapeutics · 2026Review
350 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
23 authors at 5 institutions in 2 countries.
Funding
Abstract
backgroundPatients with angina symptoms and/or signs of ischemia but no obstructive coronary artery disease (INOCA) pose a diagnostic and therapeutic challenge.
objectivesThe purpose of this study was to test whether an interventional diagnostic procedure (IDP) linked to stratified medicine improves health status in patients with INOCA.
methodsThe authors conducted a randomized, controlled, blinded clinical trial of stratified medical therapy versus standard care in patients with angina. Patients with angina undergoing invasive coronary angiography (standard care) were recruited. 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). The IDP consisted of guidewire-based assessment of coronary flow reserve, index of microcirculatory resistance, fractional flow reserve, followed by vasoreactivity testing with acetylcholine. The primary endpoint was the mean difference in angina severity at 6 months (assessed by the Seattle Angina Questionnaire summary score).
resultsA total of 391 patients were enrolled between November 25, 2016, and November 12, 2017. Coronary angiography revealed obstructive disease in 206 (53.7%). One hundred fifty-one (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 U in the Seattle Angina Questionnaire summary score at 6 months (95% confidence interval [CI]: 5.0 to 18.4; p = 0.001). In addition, the intervention led to improvements in the mean quality-of-life score (EQ-5D index 0.10 U; 95% CI: 0.01 to 0.18; p = 0.024) and visual analogue score (14.5 U; 95% CI: 7.8 to 21.3; p < 0.001). There were no differences in major adverse cardiac events at the 6-month follow-up (2.6% controls vs. 2.6% intervention; p = 1.00).
conclusionsCoronary 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. (CORonary MICrovascular Angina [CorMicA]; NCT03193294).
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.