Mode
Text Size
Log in / Sign up

CMR-Guided Care Improves Illness Perception in ANOCA PatientsNew management approach improves mental health for chest pain patients

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
CMR-guided endotype-specific management improved illness perception and psychological health in ANOCA patients at 6 and 12 months.

This multicentre randomized controlled trial evaluated whether CMR-guided endotype-specific management improves illness perception and psychological health compared with standard angiography-guided care in 250 patients with chest pain and no obstructive coronary artery disease (ANOCA).

At 6 months, illness perception scores on the Brief Illness Perception Questionnaire were significantly lower in the intervention group, with an adjusted mean difference of -8.67 (95% CI -12.04 to -5.30; P < 0.001). This improvement was sustained at 12 months, with an adjusted mean difference of -10.80 (95% CI -14.27 to -7.33; P < 0.001).

Psychological health, measured by PHQ-4 scores, also showed significant reductions at 6 months (adjusted mean difference -0.88; 95% CI -1.19 to -0.57; P < 0.001) and at 12 months (adjusted mean difference -0.97; 95% CI -1.29 to -0.65; P < 0.001).

Safety outcomes, including adverse events and discontinuations, were not reported. The study did not report funding sources or conflicts of interest, and certainty of evidence was not assessed. These findings suggest that non-invasive CMR-guided endotyping with targeted therapy may offer a clinically meaningful approach for improving illness perception and psychological well-being in the ANOCA population. However, results should be interpreted within the specific context of patients without obstructive coronary artery disease.

How this fits prior evidence

How this fits prior evidence: This finding extends previous evidence that CMR-guided management improves treatment satisfaction in patients with ANOCA. While prior evidence noted that safety and long-term outcomes were unknown in that context, this trial provides specific data on illness perception and psychological health at 6 and 12 months. It addresses a gap regarding the psychological impact of endotype-specific management in the ANOCA population.

Living with chest pain is often scary and stressful. For people with a specific condition called ANOCA, the pain is real even though their arteries are not blocked. A new study looked at how a specific management plan, guided by heart imaging called CMR, could help these patients feel better both physically and mentally.

The study followed 250 patients who received this tailored care instead of standard treatment. The results showed that patients who received the specialized management had significantly better scores for how they perceived their illness. They also showed significant improvements in their overall psychological health at both the 6-month and 12-month marks.

While the study shows that this non-invasive approach helps patients feel more confident and less distressed, it is important to remember it was specifically tested on people with ANOCA. This means the results are most clear for those whose chest pain is not caused by blocked arteries. Talk to your doctor about how these findings might apply to your specific situation.

What this means for you:
Tailored management for certain chest pain cases can significantly improve a patient's mental health and outlook.

Common questions

Who does this treatment help?

This specific management approach was tested on 250 patients with chest pain and no obstructive coronary artery disease (ANOCA). It is designed for people whose chest pain is not caused by blocked arteries, helping them manage both the physical symptoms and the mental stress of the condition.

How does it improve a patient's outlook?

Patients who received the tailored management showed significantly lower scores for illness perception at both 6 months and 12 months. This means they felt less burdened by their condition. They also showed significant improvements in their psychological health scores during the same timeframe.

Is this a new type of medication?

No, this was not a new drug. It was a change in management strategy. Instead of standard care, doctors used non-invasive heart imaging (CMR) to provide a more specific type of care tailored to the patient's specific condition.

Study Details

Study typeRct
Sample sizen = 250
EvidenceLevel 2
Follow-up6.0 mo
PublishedSep 2026
View Original Abstract ↓
AIMS: Patients with angina and no obstructive coronary artery disease (ANOCA) experience persistent symptoms, adverse illness perceptions, and psychological distress, often driven by diagnostic uncertainty. We evaluated whether non-invasive stress perfusion cardiovascular magnetic resonance (CMR), used to define ischaemic endotypes and guide targeted therapy, improves illness perception and psychological health compared with standard angiography-guided care. METHODS AND RESULTS: The Coronary microvascular angina Cardiac Magnetic Resonance imaging (CorCMR) trial was a prospective, multicentre, randomized controlled superiority trial. Patients with chest pain undergoing invasive coronary angiography showing no obstructive coronary artery disease were randomized 1:1 to CMR-guided endotype-specific management (intervention) or standard angiography-guided care (control). Illness perception was assessed using the Brief Illness Perception Questionnaire (BIPQ). Psychological health was assessed using the Patient Health Questionnaire-4 (PHQ-4). Assessments occurred at baseline, 6 months, and 12 months. A total of 250 participants were randomized (126 control, 124 intervention; mean age 63.3 years, 50.4% female). At 6 months, BIPQ scores were significantly lower in the intervention vs. control group [adjusted mean difference -8.67 (95% CI -12.04, -5.30); P < 0.001], with sustained benefit at 12 months [adjusted mean difference -10.80 (95% CI -14.27, -7.33); P < 0.001]. PHQ-4 scores were also significantly reduced at 6 months [adjusted mean difference -0.88 (95% CI -1.19, -0.57); P < 0.001] and 12 months [adjusted mean difference -0.97 (95% CI -1.29, -0.65); P < 0.001]. CONCLUSION: In patients with ANOCA, non-invasive CMR-guided endotyping linked to targeted therapy resulted in substantial and sustained improvements in illness perception and psychological health, highlighting the importance of diagnostic clarification in addressing the psychological burden of this condition.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.