Heart drugs chosen by small vessel tests for ischemia without blocked arteries
Tests drugs picked by heart vessel checks in ischemia without blockages.
Plain-language title generated from the registry record
Registry title: COronoary Microcirculation Analysis NETwork
Key facts
- Where
- Bialystok, PolandSee the site
AI summary: who the study is looking for
From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.
The trial is looking for adults aged 18 to 75 with long-lasting coronary heart disease symptoms and proven lack of blood flow to the heart muscle, without major blocked heart arteries.
- Age
- 18 Years to 75 Years
- Sex
- All sexes can join.
- Disease stage
- Chronic coronary syndrome with angina (chest pain) symptoms above CCS class I or an equivalent, and heart muscle ischemia confirmed by non-invasive testing.
- Earlier treatment
- Cannot have had a heart stent procedure (PCI) or an acute coronary syndrome within 90 days, or previous coronary bypass surgery (CABG).
Main reasons for not taking part
- Significant blockage in a coronary artery (stenosis or FFR < 0.8)
- Left ventricular ejection fraction < 40% or heart failure NYHA class III or worse
- Atrial fibrillation, or second- or third-degree heart block without a pacemaker
- Kidney function eGFR < 30 ml/min/1.73 m²
- Active cancer, type 1 diabetes, or pregnancy
Read by machine on 12 November 2026.
Could this be for you?
Answer for yourself. This is not a decision: only the study team can say whether you can take part.
- Are you between 18 and 75 years old?
Source: NCT07498231, who can take part
Where in Poland
- 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 HemodynamikiBialystok, PolandContact: Maciej A. Poludniewski, MD, PhDTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Contact the study team: see the registry record → Contacts and Locations
Print a page for my doctorTrial details
- Who runs it
- Medical University of Bialystok
- Trial code
- NCT07498231
- Record updated
- 8 April 2026
- Original description
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.Read full original descriptionShow less
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 (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.
Pharmacotherapy 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.
Participants 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).
The study began in October 2025. Primary completion is anticipated in October 2027, and the overall study completion date is expected in March 2028.
Inclusion: 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.
Exclusion: Previous coronary artery bypass grafting (CABG); Severe concomitant valvular heart disease; Manifest pre-excitation on ECG or history of AVRT episodes without prior ablation of the accessory pathway; Acute coronary syndrome within < 90 days; Active malignancy; Type 1 diabetes mellitus; 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); Heart failure ≥ NYHA class III; Renal insufficiency with eGFR < 30 ml/min/1.73 m²; Left ventricular ejection fraction < 40%; Anemia < 10 g/dL or thrombocytopenia < 100,000/µL; Angiographically significant coronary artery stenosis or FFR < 0.8; Hypertrophic cardiomyopathy; Percutaneous coronary intervention (PCI) within < 90 days; Intraventricular conduction disturbances preventing ST-T segment assessment; Pregnancy; Asthma or COPD with severe irreversible airflow obstruction; Atrial fibrillation; Second- or third-degree atrioventricular block without pacemaker implantation (IPG).