Women's IschemiA TRial to Reduce Events In Non-ObstRuctive CAD (WARRIOR)
Coronary Artery Disease
About this trial
This is an interventional treatment trial for Coronary Artery Disease focused on measuring Coronary Angiography, Coronary CT Angiogram, Ischemia, Non-obstructive CAD
Eligibility Criteria
Inclusion Criteria:
- Signs and symptoms of suspected ischemia prompting referral for further evaluation by cardiac catheterization or coronary angiogram or coronary CT angiogram within 5 years from consent
- Willing to provide written informed consent
- Non-obstructive CAD defined as 0 to 49% diameter reduction of a major epicardial vessel or a FFR>0.80
Exclusion Criteria:
- History of noncompliance (with medical therapy, protocol, or follow-up)
- History of non-ischemic dilated or hypertrophic cardiomyopathy
- Documented acute coronary syndrome(ACS) within previous 30 days
- Left ventricular ejection fraction (LVEF) <40%, New York Heart Association heart failure (NYHA HF) class III-IV, or hospitalization for Reduced ejection fraction (HFrEF) within 180 days
- Stroke within previous 180 days or intracranial hemorrhage at any time
- End-stage renal disease, on dialysis, or estimated glomerular filtration rate (eGFR) <30 ml/min.
- Severe valvular disease or likely to require surgery/Transcatheter aortic valve replacement (TVAR) within 3 years
- Life expectancy <3-yrs. due to non-cardiovascular comorbidity
- Enrolled in a competing clinical trial
- Prior intolerance to both an ACE-I and ARB
- If intolerant to a statin unless taking a PCSK9 as a statin replacement by their clinical provider
- Pregnancy (all pre-menopausal females must have negative urine pregnancy test if randomized to IMT before study drugs are prescribed. If they have not gone through menopause, had a hysterectomy, oophorectomy, or sterilization such as tubal ligation procedure)
Sites / Locations
- Cardiology Associates of Mobile, Inc.Recruiting
- Dignity Health-Mercy Gilbert Medical CenterRecruiting
- Dignity Health-St. JosephRecruiting
- University of ArizonaRecruiting
- University of ArkansasRecruiting
- Cedars-Sinai Heart InstituteRecruiting
- UCLA Medical CenterRecruiting
- Loma Linda University Health
- Lundquist Institute for Biomedical Innovation at Harbor UCLA Medical CenterRecruiting
- Georgetown UniversityRecruiting
- Clearwater Cardiovascular Consultants Clinical ResearchRecruiting
- South Palm Cardiovascular Research InstituteRecruiting
- Family Medicine at Eastside Community PracticeRecruiting
- Family Medicine at Hampton Oaks Medical Plaza (Adults and Peds)Recruiting
- Internal Medicine at Tower HillRecruiting
- Family Medicine at Haile Plantation (Adults & Peds)Recruiting
- Malcom Randall VA Medical CenterRecruiting
- Cardiovascular Clinic at UF Health UFRecruiting
- Internal Medicine at UF Health Medical PlazaRecruiting
- Spring Hill CardiologyRecruiting
- Family Medicine at 4th AveRecruiting
- Family Medicine at Old Town (Adults and Peds)Recruiting
- Baptist HealthRecruiting
- University of Florida, JacksonvilleRecruiting
- Naval Hospital JacksonvilleRecruiting
- Mayo Clinic JacksonvilleRecruiting
- UF Primary Care at Lake City SWRecruiting
- UF Primary Care at Lake City WestRecruiting
- Charles H. Croft MDPARecruiting
- Daytona Heart GroupRecruiting
- Southwest Florida Research InstituteRecruiting
- Cardiovascular Instititute of Central FloridaRecruiting
- Ocala Research Institute Inc.Recruiting
- Orlando HealthRecruiting
- Naval Hospital PensacolaRecruiting
- Cardiovascular Center of SarasotaRecruiting
- Advent SebringRecruiting
- James A. Haley Veterans HospitalRecruiting
- AdventHealth Tampa - Pepin Heart InstituteRecruiting
- Interventional Cardiac ConsultantsRecruiting
- BayCare Medical GroupRecruiting
- Guardian ResearchRecruiting
- Emory UniversityRecruiting
- Cardiovascular Consultants of South Georgia, LLC.Recruiting
- Loyola University ChicagoRecruiting
- MedicoriciumRecruiting
- Carle Foundation HospitalRecruiting
- Midwest Cardiovascular Research and Education FoundationRecruiting
- Lutheran Health PhysiciansRecruiting
- Midwest Heart and Vascular SpecialistsRecruiting
- Western Kentucky Heart And LungRecruiting
- The Research Group of Lexington, LLCRecruiting
- University of Kentucky
- Tulane University Heart and Vascular Institute
- Walter Reed National Military Medical CenterRecruiting
- Berkshire Medical CenterRecruiting
- Mid Michigan HealthRecruiting
- Essentia Institute of Rural HealthRecruiting
- Minneapolis Heart Institute FoundationRecruiting
- Cardiology Associates Research, LLCRecruiting
- Cardiology Associates Research. LLCRecruiting
- CHI Health Research CenterRecruiting
- Silver State CardiologyRecruiting
- The Valley HospitalRecruiting
- Bassett Healthcare NetworkRecruiting
- NYU LangoneRecruiting
- Weil Medical college of CornellRecruiting
- Jamaica Hospital Medical Center
- Peak Clinical Trials, LLCRecruiting
- Pinehurst Medical ClinicRecruiting
- The Christ HospitalRecruiting
- Trihealth Heart InstituteRecruiting
- Heart House Research FoundationRecruiting
- Seton Heart InstituteRecruiting
- Austin HeartRecruiting
- Brooke Army Medical CenterRecruiting
- San Antonio Endovascular and Heart InstituteRecruiting
- Baylor Scott and WhiteRecruiting
- University of Virginia Health SystemRecruiting
- Chippenham HospitalRecruiting
- Carilion ClinicRecruiting
- West Virginia UniversityRecruiting
- VA Caribbean Healthcare SystemRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Intensive Medical Treatment (IMT)
Usual Care (UC)
The IMT-assigned women will receive high dose potent statin, and moderate dose of an ACE-I (lisinopril) or ARB (losartan). Aspirin will also be recommended to IMT women without contraindications or bleeding risk. This group will also receive Lifestyle Counseling (PACE Assessment), Quality of Life questionnaires, and the same visit schedule and "face-time" with site staff to reduce bias.
The UC-assigned women will maintain standard of care. This group will also receive Lifestyle Counseling (PACE Assessment), Quality of Life questionnaires, and the same visit schedule and "face-time" with site staff to reduce bias.