A doctor at Christ Hospital has a $3.6 million grant from the National Institutes of Health to study a possible new treatment for a form of a heart disease that disproportionately affects women and is frequently misdiagnosed.
Medical Director Dr. Odayme Quesada leads The Christ Hospital's Women's Heart Center, where she's been researching and studying treatments for patients with angina with nonobstructive coronary artery disease (ANOCA), which is a syndrome of coronary microvascular disease (CMD).
Coronary microvascular disease affects tiny arteries that supply blood to the heart. Essentially, people have chest or heart pain but don't have any blockages in their heart arteries.
"We are looking to see if we can find an innovative new treatment, and in this study, we're going to be studying SGLT2 inhibitors," Quesada tells WVXU.
The study will enroll 120 patients over five years. Quesada and her team want to determine if a drug used to treat type 2 diabetes and heart failure could be an effective treatment for CMD for women and men with ANOCA.
"This is very exciting because this would be the largest mechanistic study that has the potential to study an innovative treatment in this patient population that's largely understudied, and with a focus on determining if we can actually reverse underlying corneal microvascular dysfunction," she explains. "Not just seeing if it affects the angina — which is the chest pain, we hypothesize that this treatment could improve chest pain — but what we really want to look at is whether it reverses the underlying disease."
Nearly a million people complaining of chest pain get tested in the U.S. each year for obstructive coronary artery disease, but only around 30% are found to have significant blockages. That means up to 70% are having symptoms like chest pain and pressure, shortness of breath and other cardiac issues without what many might think is the "obvious" cause.
"This syndrome of ANOCA is present in millions of patients in the United States and even more throughout the world, and so it is a large issue. The problem is that a lot of these patients are being unrecognized and under-treated. Essentially, once a patient is found to have open arteries, they're told that their chest pain is non-cardiac," Quesada says.
The pain isn't in your head
WVXU first reported on Quesada's work in 2023, when Patti Hutton of Liberty Township was finally diagnosed with CMD after 15 years of chest pains.
"I had really bad chest pain — like an elephant sitting on my chest at times. I was short of breath, stabbing pains. It was really uncomfortable and it would come on any time of the day," she told WVXU. "It could be when I was resting or if I was exercising. [It would] wake me up in the middle of the night."
Despite repeated doctor visits and testing, her doctors couldn't make it stop. She didn't have any arterial blockages — it wasn't a heart attack, they told her. It wasn't indigestion. It kept her from doing the things she loved. She frequently skipped out on going places, like on vacation, because she just didn't feel well. Sometimes she felt like no one believed her pain was real.
She was preparing for open heart surgery when Quesada diagnosed her with CMD.
"I think I cried," she said. "It was really good to know that it wasn't in my head, there was something wrong, and there were options out there for me so I could have a normal life."
The Christ Hospital study will be done in conjunction with researchers at the University of Cincinnati. The team expects to begin enrolling patients this fall in Cincinnati.
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