Effect of Trimetazidine on the Improvement of Coronary Microvascular Dysfunction in Patients With INOCA(Ischemia and no Obstructive Coronary Artery Disease)

Study Overview
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Brief Summary
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This is a prospective study which aims to explore the effect of Trimetazidine on the improvement of coronary microvascular dysfunction in patients with INOCA (ischemia and no obstructive coronary artery disease). Enrolled patients will be assessed SAQ(Seattle Angina Score), Canadian Angina Grade(Canadian Cardiovascular Society, CCS), Six-Minute Walk Test, CFR(coronary flow reserve) .CFR inspection with D-SPECT and pressure guide wire.Patients will receive six months Trimetazidine(35mg tid) after enrollment. And their SAQ (Seattle Angina Score), Canadian Angina Grade(Canadian Cardiovascular Society, CCS), Six-Minute Walk Test, CFR will be followed up.

Official Title
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Effect of Trimetazidine on the Improvement of Coronary Microvascular Dysfunction in Patients With INOCA(Ischemia and no Obstructive Coronary Artery Disease)

Conditions
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Patients With INOCA(Ischemia and no Obstructive Coronary Artery Disease) Who Have Coronary Microvascular Dysfunction

Intervention / Treatment
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* Drug: Trimetazidine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age≥18 years Typical angina symptoms Coronary angiography or coronary computed tomography examination showed no significant epicardial coronary artery stenosis (<20%) Never used trimetazidine The CFR measured by the pressure guide wire is less than 2.0 agree to participant the study and sign informed written consent available for six months follow up Exclusion Criteria: Severe liver and kidney disease Contraindications of Trimetazidine Use of CYP3A inhibitors, such as diltiazem, verapamil, and other drugs that may affect CFR measurements QT interval extension Atrial fibrillation or left bundle branch block Left ventricular systolic dysfunction (EF <55%) Coronary artery fistula Myocardial bridge Non-cardiogenic chest pain and other heart diseases Severe heart valve disease Diabetes Recent ACS( Acute coronary syndrome) Pregnancy Failed to complete inspection

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Trimetazidine<br> | Drug: Trimetazidine<br>* After enrollment, experimental group will receive Trimetazidine(35mg tid) for six months .<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Coronary flow reserve (CFR) improves |  | six months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Seattle angina score or Canadian angina grade drops |  | six months | 
| Six-minute walking experiment improves |  | six months |