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Effect of Dapagliflozin on Microvascular Function in Women With Symptoms of Coronary Artery Disease (SMILE)

Primary Purpose

Myocardial Ischemia

Status
Recruiting
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Dapagliflozin 10mg Tab
Placebo
Sponsored by
University of Virginia
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myocardial Ischemia

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria: Willing to provide written informed consent. Signs and symptoms of suspected ischemia that prompted referral for further evaluation by cardiac catheterization or coronary computed tomography within two years of consent. No evidence of obstructive epicardial coronary artery disease (stenosis >50%) of a major epicardial vessel (>3mm) or a fractional flow reserve >0.80 by invasive catheterization or coronary computed tomography. (Participants who have not undergone cardiac catheterization or coronary angiogram within the last 2 years for their clinical care will be screened with computed angiogram of the coronary arteries to confirm eligibility). Estimated glomerular filtration rate ≥30ml/min/1.73m2 at enrollment For subjects having a history of type 2 diabetes mellitus: approval of diabetes care/prescribing provider Exclusion Criteria: History of non-ischemic cardiomyopathy with left ventricular ejection fraction <40% or hypertrophic cardiomyopathy. History of congestive heart failure, severe pulmonary disease, liver disease History of Acute coronary syndrome within previous 30 days Stroke within the last 180 days or intracranial hemorrhage at any time. Severe Valvular disease Life expectancy <3 years, due to non-cardiovascular comorbidity. Pregnancy or women who are breast-feeding Type 1 diabetes mellitus History of diabetic ketoacidosis in subjects with Type 2 Diabetes Mellitus Symptomatic hypotension or systolic blood pressure <95 mmHg on 2 consecutive measurements Active malignancy requiring treatment at the time of visit Severe, unstable, or rapidly progressing renal disease at the time of randomization History of recurrent urinary tract, bladder, or kidney infections

Sites / Locations

  • University of VirginiaRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Dapagliflozin

Placebo

Arm Description

Dapagliflozin 10mg oral tablet.

Placebo matching tablet.

Outcomes

Primary Outcome Measures

Change in myocardial perfusion reserve
Myocardial microvascular perfusion, defined as myocardial perfusion reserve as assessed by stress cardiac magnetic resonance imaging

Secondary Outcome Measures

Full Information

First Posted
January 9, 2023
Last Updated
May 8, 2023
Sponsor
University of Virginia
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1. Study Identification

Unique Protocol Identification Number
NCT05762952
Brief Title
Effect of Dapagliflozin on Microvascular Function in Women With Symptoms of Coronary Artery Disease
Acronym
SMILE
Official Title
A Single-center, Randomized, Double-blind, Placebo-controlled Study to Evaluate Microvascular Disease After 12 Weeks of Therapy With Sodium-glucose Co-transporter 2 Inhibitor Compared to Placebo in Symptomatic Women With Non-obstructive Coronary Artery Disease
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 24, 2023 (Anticipated)
Primary Completion Date
April 30, 2024 (Anticipated)
Study Completion Date
June 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Virginia

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The goal of this clinical trial is to test the effects of a drug (in the drug class called sodium-glucose cotransporter 2 inhibitors) in women who have symptoms of ischemic heart disease. The main questions the study aims to answer are: Does blood flow in the heart improve with study drug? Participants will be randomly assigned to a 12-week course of the study drug, dapagliflozin 10mg, or placebo. Blood flow in the heart will be assessed using stress cardiac magnetic resonance imaging at baseline and 12 weeks. The researchers will compare the results from the two groups.
Detailed Description
This single-center clinical investigation is a randomized, double-blind, placebo controlled trial of dapagliflozin in women who have symptoms of myocardial ischemia but in whom obstructive coronary artery disease has been ruled out by testing within 2 years. Aim: Determine whether dapagliflozin improves coronary blood flow in women. Participants will be randomly assigned to a 12-week course of dapagliflozin 10mg oral or placebo. Participants will complete study assessments at baseline, 6 weeks of treatment, and 12 weeks of treatment. Peak myocardial blood flows at rest and with pharmacological stress will be assessed using cardiac magnetic resonance imaging at baseline and 12 weeks. Symptom surveys and lab work will be collected at baseline, 6 weeks, and 12 weeks of treatment. Participants will be closely monitored throughout study participation for adverse events. Results will be captured in a database and published in a peer-reviewed journal.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myocardial Ischemia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Pharmacy will manage the randomization of study participants. Assignments will not be unmasked until all outcomes have been assessed.
Allocation
Randomized
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Dapagliflozin
Arm Type
Experimental
Arm Description
Dapagliflozin 10mg oral tablet.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo matching tablet.
Intervention Type
Drug
Intervention Name(s)
Dapagliflozin 10mg Tab
Other Intervention Name(s)
active drug
Intervention Description
Once daily oral dapagliflozin 10mg
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Placebo matching tablet
Intervention Description
Placebo capsules formulated by pharmacy to be indistinguishable from active drug
Primary Outcome Measure Information:
Title
Change in myocardial perfusion reserve
Description
Myocardial microvascular perfusion, defined as myocardial perfusion reserve as assessed by stress cardiac magnetic resonance imaging
Time Frame
Baseline and after 12 weeks of treatment

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Willing to provide written informed consent. Signs and symptoms of suspected ischemia that prompted referral for further evaluation by cardiac catheterization or coronary computed tomography within two years of consent. No evidence of obstructive epicardial coronary artery disease (stenosis >50%) of a major epicardial vessel (>3mm) or a fractional flow reserve >0.80 by invasive catheterization or coronary computed tomography. (Participants who have not undergone cardiac catheterization or coronary angiogram within the last 2 years for their clinical care will be screened with computed angiogram of the coronary arteries to confirm eligibility). Estimated glomerular filtration rate ≥30ml/min/1.73m2 at enrollment For subjects having a history of type 2 diabetes mellitus: approval of diabetes care/prescribing provider Exclusion Criteria: History of non-ischemic cardiomyopathy with left ventricular ejection fraction <40% or hypertrophic cardiomyopathy. History of congestive heart failure, severe pulmonary disease, liver disease History of Acute coronary syndrome within previous 30 days Stroke within the last 180 days or intracranial hemorrhage at any time. Severe Valvular disease Life expectancy <3 years, due to non-cardiovascular comorbidity. Pregnancy or women who are breast-feeding Type 1 diabetes mellitus History of diabetic ketoacidosis in subjects with Type 2 Diabetes Mellitus Symptomatic hypotension or systolic blood pressure <95 mmHg on 2 consecutive measurements Active malignancy requiring treatment at the time of visit Severe, unstable, or rapidly progressing renal disease at the time of randomization History of recurrent urinary tract, bladder, or kidney infections
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Caroline L Flournoy, PhD
Phone
4349246104
Email
clf4w@uvahealth.org
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Caroline L Flournoy, MD
Organizational Affiliation
University of Virginia Health System
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Caroline L Flournoy
Phone
434-924-6104
Email
clf4w@uvahealth.org
First Name & Middle Initial & Last Name & Degree
Patricia Rodrguez, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Effect of Dapagliflozin on Microvascular Function in Women With Symptoms of Coronary Artery Disease

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