Table 3

Proposed comprehensive research strands for patients with ischaemia and no obstructive coronary artery disease (INOCA)

Comprehensive INOCA research strands
Stratified medicine trials
  • Diagnostic tests (rule-in/rule-out)

  • Stratification of endotypes for evidence-based therapy

Vascular science
  • Investigations of disease mechanisms, for example, endothelial dysfunction and dysregulation of the endothelin system

Imaging and modelling
  • Clinical trials of quantitative perfusion CMR versus standard methods

  • Patient-specific computed models of disease to predict responses to novel therapeutics

Molecular pathology and vascular histopathology
  • Protein assay-based scores and genetic variants are potential biomarkers for disorders of coronary function.

  • Identification of drug targets

Therapeutic trials
  • Enhanced system antagonists

  • Vasodilating ß-blockers

  • Lifestyle interventions, for example, exercise, weight loss

Health informatics and value assessments
  • Assess the cost-effectiveness of innovative stratified approaches

Patient and public involvement
  • Ensures relevance of research to patients and carers