Evidence map›Paper›PMID 41214345›Full record

Trial reportNature medicine2026

Endotyping-informed therapy for patients with chest pain and no obstructive coronary artery disease: a randomized trial.

Conor P Bradley, Gemma McKinley, Vanessa Orchard, Christina Tiller, Beth Stanley, Daniel Ang, Andrew J Morrow, Robert Sykes, Pamela Gildea, Maria Petty and 18 more

Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Nature medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04805814 (The Clinical Utility Of Cardiac Magnetic Resonance Imaging in Patients With Angina But No Obstructive Coronary Disease), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04805814 naactive not recruitingnot on this map

The Clinical Utility Of Cardiac Magnetic Resonance Imaging in Patients With Angina But No Obstructive Coronary Disease (CorCMR): A Diagnostic Study And Nested Randomised Trial

TypeinterventionalSponsorNHS National Waiting Times Centre BoardRan2021 to 2034Enrolled280ConditionsMicrovascular Angina, Angina Pectoris, Angina, Stable, Non-Obstructive Coronary AtherosclerosisArmsCMR results disclosed, CMR performed but results not disclosed
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

28 authors.

Conor P BradleyBritish Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Gemma McKinleyRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.
Vanessa OrchardGolden Jubilee University National Hospital, Clydebank, UK.
Christina TillerInternal Medicine III, Cardiology & Angiology, Innsbruck Medical University, Innsbruck, Austria.
Beth StanleyRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.
Daniel AngBritish Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Andrew J MorrowBritish Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Robert SykesBritish Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.ORCID 0000-0003-1010-5474
Pamela GildeaGolden Jubilee University National Hospital, Clydebank, UK.ORCID 0009-0000-8283-5113
Maria PettyGolden Jubilee University National Hospital, Clydebank, UK.
Richard BroganGolden Jubilee University National Hospital, Clydebank, UK.ORCID 0000-0003-2265-0488
David CarrickDepartment of Cardiology, University Hospital Hairmyres, East Kilbride, UK.
Damien CollisonGolden Jubilee University National Hospital, Clydebank, UK.
Hany EteibaGolden Jubilee University National Hospital, Clydebank, UK.
Angie GhattasGolden Jubilee University National Hospital, Clydebank, UK.
Richard GoodBritish Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.ORCID 0000-0002-3906-1025
Francis JoshiGolden Jubilee University National Hospital, Clydebank, UK.
Mitchell LindsayGolden Jubilee University National Hospital, Clydebank, UK.
Peter McCartneyGolden Jubilee University National Hospital, Clydebank, UK.
James McGowanDepartment of Cardiology, University Hospital Ayr, Ayr, UK.
Ross McGeochDepartment of Cardiology, University Hospital Hairmyres, East Kilbride, UK.
Keith RobertsonGolden Jubilee University National Hospital, Clydebank, UK.ORCID 0000-0002-6557-8298
Paul RocchiccioliGolden Jubilee University National Hospital, Clydebank, UK.
Aadil ShaukatGolden Jubilee University National Hospital, Clydebank, UK.
Stuart WatkinsBritish Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Peter KellmanNational Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
Alex McConnachieRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.ORCID 0000-0002-7262-7000
Colin BerryBritish Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK. colin.berry@glasgow.ac.uk.ORCID 0000-0002-4547-8636

Funding

British Heart Foundation (BHF) PG/19/28/34310
6 · The paper itself

Abstract

Patients undergoing invasive coronary angiography for the investigation of chest pain commonly do not have obstructive coronary artery disease. In contemporary practice, most of these individuals do not undergo functional diagnostic tests, leaving the cause of the chest pain uncertain. Stress cardiovascular magnetic resonance imaging (MRI) can be used to measure myocardial blood flow, detect coronary microvascular dysfunction and endotype individual patients, but evidence of clinical utility from randomized trials is lacking. This study was a prospective, multicenter, parallel group, 1:1 randomized, controlled superiority trial of adenosine stress cardiovascular MRI-guided management in 250 patients (mean age, 63.3 years; 50.4% female) with chest pain and unobstructed coronary arteries. The primary outcome of the diagnostic study, defined as the reclassification of the initial diagnosis based on the angiogram, occurred in 131 patients (53.0% (95% confidence interval: 46.6-59.3%); P < 0.001), indicating that the primary outcome for the diagnostic study was met. The primary outcome of the randomized trial was the Seattle Angina Questionnaire (SAQ) summary score at 12 months after randomization. The mean ± s.d. SAQ summary scores at 12 months in the intervention and control groups were 70.9 ± 23.6 (21.7 ± 22.6 change from baseline) and 52.1 ± 24.1 (-0.8 ± 20.4 change from baseline) (adjusted mean difference: 20.9 (95% confidence interval: 15.8-26.0)), respectively, indicating that the primary outcome of the randomized trial was met. Improvements were also observed in the prespecified secondary outcome of the EQ-5D-5L questionnaire at 12 months (adjusted mean difference 0.09 (95% confidence interval: 0.04-0.13)). In this study of patients with chest pain and unobstructed coronary arteries, endotyping-informed therapy revised the diagnosis in more than half of the participants and improved angina and health-related quality of life. ClinicalTrials.gov identifier: NCT04805814 .

Indexed as

Chest PainCoronary Artery DiseaseAgedCoronary AngiographyCoronary VesselsFemaleHumansMagnetic Resonance ImagingMaleMiddle AgedProspective Studies

Identifiers

PMID41214345
PMCPMC12823439

What Socratic holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.