Quality of Life Clinical Trial
Official title:
Effect of Amlodipine Versus Amlodipine Combined With Atorvastatin on the Symptoms, Function, and Quality of Life in Patients With Coronary Vasospastic Angina
The aim of the present study is to compare the effects of CCB and CCB+ high dose of statin therapy on the symptoms, function, and quality of life assessed by validated angina-specific questionnaire (Short-form Seattle Angina Questionnaire (SAQ-7)), endothelial function as measured by FMD of the brachial artery, endothelial progenitor cells (EPC) and coronary flow reserve (CFR) in patients with VSA.
STUDY DESIGN Study protocol Study Start (expected FSFV (First subject first visit )) at
August 1 2016 Study Stop (expected LSLV (Last subject last visit)) at February 29 2019 150
Patients with confirmed VSA who had over 3 episodes of angina per week during a over 2 week
qualification period are randomly assigned to receive either amlodipine therapy (NORVASC 10
mg/day) or amlodipine/atorvastatin combination (CADUET 10/20mg) for 6 months. The starting
dose of the drung is either 5mg amlodipine or 5/20mg CADUET. After 4 weeks, if the 5mg
amlodipine is well tolerated, the dose is titrated to 10mg and 10/20mg CADUET. All other
antianginal medications are proscribed during the study period except long-acting nitrates
and sublingual nitroglycerin as required. Long-acting nitrates are permitted during the study
period if they had been taken at a constant dosage for over 2 weeks before study entry.
Participants are allowed to take sublingual NTG as needed for episodes of chest pain.
Study design. Patients with VSA who had over 1 angina episodes/week confirmed by ergonovine
provocation test Acquisition of written consent Randomization to NORVASC 10 mg/day or CADUET
10/20 mg Baseline SAQ, angina diary, FMD, EPC, CFR assessments are performed. Medication
start with either 5mg NORVASC or 5/20mg CADUET. After 4 weeks, if the 5mg amlodipine is well
tolerated, titrate to 10mg and 10/20mg CADUET. Routine visit with the scheduled reservation
(2 or 3 months interval) After 6-months treatment, follow-up SAQ, angina diary, FMD, EPC, CFR
assessments are performed (mandatory).
After 12-months treatment, follow-up SAQ, angina diary, FMD, EPC, CFR assessments are
performed (optional).
Efficacy assessments. The primary efficacy variable is the change of summary score of SAQ-7
between NORVASC 10mg/day and CADUET 10/20mg, and the weekly average frequency of
self-reported angina episodes during the 6-months treatment phase. Difference of Summary
score of SAQ 7 is calculated between the baseline (at the enrollment before randomization)
and the after 6-months treatment. The study staff at each clinical site will review the
angina and nitroglycerin use diaries with the patient at each study visit.
Assessment of patient responses by short form SAQ at baseline and after 6 months treatment.
The Seattle Angina Questionnaire (SAQ) is a validated disease-specific instrument for
assessing the health status of patients with coronary artery disease. Although the SAQ has
been frequently used in clinical trials and registries, its use in routine clinical care has
been limited by its length (19 questions) and the absence of a single summary score that
facilitates an overall assessment of patients' health status.
Recently, 7-item from the Physical Limitation, Angina Frequency, and Quality of Life domains
for the shortened version of the SAQ (SAQ 7), as well as an overall summary score was
developed and validated in patients with stable coronary artery disease, undergoing
percutaneous coronary intervention, and presenting with acute myocardial infarction.
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