Diagnostic Imaging for Coronary Heart Disease
(SWAN Trial)

Recruiting in Palo Alto (17 mi)

Overseen ByHarmony Reynolds, M.D.

Age: 18+

Sex: Female

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: NYU Langone Health

No Placebo Group

Trial Summary

What is the purpose of this trial?Approximately 600,000 women are treated for acute coronary syndrome (ACS) annually in the US. ACS includes heart attack and a milder form called unstable angina. Many of these women have angiograms of which 14-39% show no "significant" coronary artery disease (CAD, cholesterol plaque accumulation in arteries of the heart). The remaining majority of women with ACS have cholesterol plaque buildup which appears severe enough on angiography to limit blood flow to the heart. It is difficult to advise women with heart attacks and no major heart artery blockages on what to do if chest pain happens again. Additional studies are needed to find out why this sort of heart attack happens and to help doctors understand how to treat patients who have this problem in the best possible way. Some women with heart attacks who have no major blockage in heart arteries have cholesterol plaque in the arteries of the heart cannot be seen on angiography but can be seen using a newer technique called intravascular ultrasound (IVUS). IVUS involves creating pictures of the artery walls using ultrasound (sound waves) from within the artery itself. In some women without major heart artery blockage, heart attack is caused by low blood flow due to disease of smaller blood vessels which cannot be seen on angiography or IVUS. This problem can be found using magnetic resonance imaging (MRI), which can show blood flow to the heart. MRI may also be used to show where the heart has been damaged. The pattern of damage could suggest that a heart attack in a woman, who has no badly blocked heart arteries, happened for one (or more) of these reasons or another reason. The Study of Women with ACS and Non-obstructive CAD (SWAN) will use IVUS and MRI to help determine the reasons for heart attacks in women with no major blockages in heart arteries.

Eligibility Criteria

This trial is for women who have had a heart attack or unstable angina and are scheduled for an angiography, but do not have major blockages in their heart arteries. Women with previous obstructive coronary artery disease, those who can't undergo IVUS or MRI procedures, or those using vasospastic agents cannot participate.

Inclusion Criteria

I am a woman with heart issues scheduled for a heart vessel check.

Exclusion Criteria

I have been diagnosed with blocked arteries in my heart.

You cannot have an intravascular ultrasound (IVUS) or magnetic resonance imaging (MRI) for medical reasons.

I am taking medication for blood vessel spasms.

Participant Groups

The study uses intravascular ultrasound (IVUS) to take pictures of the inside of arteries and magnetic resonance imaging (MRI) to assess blood flow and damage in the heart. It aims to understand why some women experience heart attacks despite having no significant blockage in their arteries.

1Treatment groups

Experimental Treatment

Group I: WomenExperimental Treatment2 Interventions

IVUS and MRI performed in women with no obstructive CAD at angiography