Comparison of risk profiles of participants in the Women's IschemiA TRial to reduce events in non-ObstRuctive CAD (WARRIOR) trial, using coronary computed tomography angiography vs invasive coronary angiography.

To compare baseline characteristics of participants in the Women's IschemiA TRial to Reduce Events In Non-ObstRuctive CAD (WARRIOR) trial by qualification by Coronary Computed Tomography Angiography (CCTA) or Invasive Coronary Angiography (ICA). The WARRIOR trial (NCT03417388) is an ongoing multicenter, prospective, randomized, blinded outcome evaluation of intensive medical therapy vs. usual care in women with suspected Ischemia and No Obstructive Coronary Artery Disease (INOCA) identified by either CCTA or ICA on the outcome of major adverse cardiovascular events (MACE). No coronary artery disease is defined as <50% luminal stenosis and normal coronary arteries is defined as no evidence of atherosclerosis including calcified and non-calcified plaque. Data presented was extracted on May 27, 2020. No clinical outcomes were assessed. An initial sample cohort of 797 women was included. The majority were younger than 65 years, White participants (73.3%), 159 had diabetes (19.9%), and 676 had angina (84.8%) with the remainder having symptoms of suspected ischemic heart disease. Over 50% of randomized participants had normal coronaries without luminal irregularities by ICA or CCTA. Participants randomized to ICA were more likely to have worse baseline clinical risk profiles with older age, higher burden of cardiac risk factors and poor quality of life with disabling angina. Among this initial sample of women with suspected INOCA randomized in the WARRIOR trial, there is a differential baseline cardiac risk of participants enrolled after CCTA or ICA. However, the majority had no evidence of atherosclerotic plaque or obstructive stenosis, after evaluation by ICA or CCTA. These results suggest that non-invasive evaluation with CCTA is likely to be associated with lower risk of MACE.

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Copyright © 2024. Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest CNBM serves as Board of Director for iRhythm and receives personal fees paid to CSMC bySHL Telemedicine. CJP receives research grants from GE Healthcare, Merck, Sanofi, CLS Behring, BioCardia, McJunkin Family Foundation Trust, Brigham & Women's Hospital, Gatorade Trust through the University of Florida Department of Medicine, and Mesoblast, Inc.; has received consultant fees/honoraria from Verily Life Sciences. LLC Project Baseline OSMB (Google), Ironwood, XyloCor, Slack Inc., Elsevier, Imbria Pharmaceuticals, Milestone Pharmaceuticals Inc., AstraZeneca Pharmaceuticals, and Sanofi-Aventis. SL has no disclosures. MB has received grant support from NIH and GE. GC has no disclosures. LS has received honoraria for speaking from Elucid Bioimaging and Heartflow.