ACCEL Lite: WARRIOR Trial: Outcomes to Reduce Events in Non-Obstructive Coronary Artery Disease

May 06, 2025   |  Nanette Kass Wenger, MD, MACC; C. Noel Bairey Merz, MD, MACC

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Funded by the Congressionally Directed Medical Research Programs (CDMRP) of the Department of Defense, the WARRIOR (Women's IschemiA TRial to Reduce events In non-ObstRuctive CAD) Trial addresses the urgent need for evidence-based care in a growing population of patients—particularly women—experiencing ischemia without obstructive coronary artery disease (INOCA).

This clinical strategy trial compares optimal medical therapy with usual care in women with angina but no significant coronary blockages. In this episode, Drs. Nanette Kass Wenger and Noel Bairey Merz discuss the trial’s design, enrollment progress, follow-up strategies, and the primary and secondary outcomes that could reshape cardiovascular care for women.

Related References:

  1. Handberg EM, Merz CNB, Cooper-Dehoff RM, Wei J, Conlon M, Lo MC, Boden W, Frayne SM, Villines T, Spertus JA, Weintraub W, O'Malley P, Chaitman B, Shaw LJ, Budoff M, Rogatko A, Pepine CJ. Rationale and design of the Women's Ischemia Trial to Reduce Events in Nonobstructive CAD (WARRIOR) trial. Am Heart J. 2021 Jul;237:90-103. doi: 10.1016/j.ahj.2021.03.011.
  2. Dasa O, Handberg E, Dey D, Sarder P, Lo MC, Tamarappoo BK, Smith SM, Shaw LJ, Merz CNB, Pepine CJ. QUIET WARRIOR - Rationale and design: An ancillary study to the Women's IschemiA TRial to Reduce Events in Nonobstructive CAD (WARRIOR). Am Heart J Plus. 2025 Jan 31;51:100508. doi: 10.1016/j.ahjo.2025.100508.
  3. Lakshmanan S, Wei J, Cook-Wiens G, Pepine CJ, Handberg EM, Shaw LJ, Budoff M, Merz CNB. Comparison of risk profiles of participants in the Women's IschemiA TRial to Reduce events In non-ObstRuctive CAD (WARRIOR) trial, using Coronary Computed Tomography Angiography vs Invasive Coronary Angiography. Prog Cardiovasc Dis. 2024 May-Jun;84:90-93. doi: 10.1016/j.pcad.2024.03.008.
  4. Keeley EC, Li HJ, Cogle CR, Handberg EM, Merz CNB, Pepine CJ. Specialized Proresolving Mediators in Symptomatic Women With Coronary Microvascular Dysfunction (from the Women's Ischemia Trial to Reduce Events in Nonobstructive CAD [WARRIOR] Trial). Am J Cardiol. 2022 Jan 1;162:1-5. doi: 10.1016/j.amjcard.2021.09.015.
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Clinical Topics: Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention, Stable Ischemic Heart Disease

Keywords: ACCELLite, ACC25