Detection of Significant Coronary Artery Disease by Promising Biomarker: A2A Adenosine Receptor (A2AR) Assays

Inclusion criteria

• Man or woman aged ≥18 and <90 years old;
• Must not be of child-bearing potential (≥1 year post-menopausal, contraceptive, or surgically sterile);
• Symptoms suggestive of CCS and intermediate PTP (15-85%) according to the Diamond classification (2);
• Undergone at least one stress imaging test (annex 3) or an abnormal coronary Computed Tomography Angiography (CTA) with the recommendation to perform ICA with FFR in all intermediate lesions;
• Non-contributive ECG (resting 18-lead);
• Normal echocardiography with left ventricular ejection fraction (LVEF) >50%;
• Cardiac troponin level <99th percentile;
• Intended for an invasive strategy for CCS;
• Affiliated to or beneficiary of, a social security system;
• Signed written informed consent.

Exclusion criteria

Persons referred in articles L.1121-5 to L.1121-8 and L.1122-2 of the Public Health Code:

• Pregnant, parturient or breastfeeding woman
• Person deprived of liberty for judicial or administrative decision
• Person under psychiatric care
• Minor person (non-emancipated)

• History of CAD or known CAD
• Suspected acute coronary syndrome (ACS: annex 4)
• Inability to undergo adenosine testing
• Allergy to iodinated contrast media
• Bleeding diathesis
• Known significant bleeding risk according to physician judgment
• Severe hepatic failure (ASAT, ALAT>3ULN)
• Ischemic stroke within 1 month or a history of hemorrhagic stroke
• Bradycardia
• Platelet count <100 G/L
• Hemoglobin <10g/dl
• Major surgery or trauma within 10 days
• Life expectancy <1 year
• Pre-test Probability <15% or >85%
• History and clinical examination suggesting non-cardiac chest pain
• Contraindication to coronary angiography
• Thyroid disorder
• Refusal to participate