Beta-blockers to improve coronary blood flow and resistance in people with angina and no blocked coronary arteries
Official title: Effect of Beta-blockers on Coronary Flow and Resistance in Patients With ANOCA: a Randomised, Placebo-controlled, Mechanistic Study
Run by VZW Cardiovascular Research Center Aalst · NCT06864234 · Data updated 2026-11-12
This trial will see if a beta-blocker (metoprolol) helps people with angina but no obstructive coronary arteries by improving coronary blood flow and lowering small-vessel resistance compared with a placebo.
Quick facts
| Phase | Phase 4 |
|---|---|
| Study type | Interventional |
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 46 (estimated) |
| Sponsor | VZW Cardiovascular Research Center Aalst Academic / other |
| Locations | 1 site (Aalst, Flanders) |
| Status | Recruiting |
| Started | July 3, 2025 |
| Main results expected | December 31, 2025 |
| Study ends | December 31, 2025 |
| Registry record updated | July 14, 2025 |
| Trial ID | NCT06864234 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults having diagnostic coronary angiography for angina who are found to have ANOCA (FFR >0.80, no stenosis >50%, TIMI 3 flow), with stable hemodynamics, heart rate ≥60 bpm, systolic blood pressure ≥100 mmHg, and LVEF ≥40% are ideal candidates.
✕Probably not a fit
Patients with clinical heart failure, severe valvular disease needing intervention, prior CABG, tortuous coronary anatomy, heart rate <60 bpm, systolic BP <100 mmHg, LVEF <40%, or inability to consent are excluded and unlikely to benefit from this protocol.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
Adults undergoing diagnostic coronary angiography who are found to have angina with no obstructive coronary arteries (ANOCA) will receive either metoprolol or a saline placebo and will have specialized intracoronary thermodilution measurements of absolute coronary flow and microvascular resistance before and after treatment. The main comparisons are changes in absolute coronary flow and microvascular resistance between the beta-blocker and placebo groups. Key eligibility requirements include FFR >0.80, no diameter stenosis >50%, TIMI 3 flow, and stable hemodynamics. Patients with heart failure symptoms, severe valvular disease, prior CABG, very low heart rate or blood pressure, or LVEF <40% are excluded.
Why it matters
Potential benefit: If successful, this could show that an inexpensive, widely available beta-blocker improves coronary circulation in ANOCA and help guide treatment decisions to reduce symptoms.
How similar studies have gone: Guidelines and prior studies support beta-blocker use for symptomatic microvascular dysfunction, but direct evidence that beta-blockers improve absolute coronary flow and microvascular resistance is limited and has produced mixed results.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients undergoing diagnostic coronary angiography for suspected angina pectoris who are found to have ANOCA i.e. an FFR \>0.80 and no diameter stenosis \>50% * Normal, TIMI 3 flow at angiography * Stable haemodynamics Exclusion Criteria: * Clinical signs or symptoms of congestive heart failure * Severe valvular heart disease requiring either surgical or percutaneous intervention * History of coronary artery bypass grafting * Tortuous coronary anatomy in which wire manipulation could be complex * Heart rate \<60 beats per minute * Systolic blood pressure \<100 mmHg * Unable to give consent * LVEF\<40%
Where it's running
-
OLV Cardiovascular Center Aalst
Aalst, Flanders, Belgium Recruiting
Study contacts
- Study coordinator: Adriaan Wilgenhof, MD
- Email: adriaan.wilgenhof@azorg.be
- Phone: +32 53 72 44 39
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.