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

• 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