The WARRIOR Project

Full Title: WARRIOR: Women’s IschemiA TRial to Reduce Events In Non-ObstRuctive CAD
Carl Pepine, M.D.
Eileen Handberg, Ph.D. ARNP
PI Institution: University of Florida
Study Staff:
Jane-Ann Norton, Trinity Cromwell

Funding Agency: Department of Defense (DoD)

Abstract: The proposed WARRIOR (Women’s Ischemia Trial to Reduce Events In Non-Obstructive CAD) trial is a multicenter, prospective, randomized, blinded outcome evaluation (PROBE design) evaluating IMT vs. GMT in 4,422 symptomatic women with ischemia but no obstructive CAD. The hypothesis is that IMT will reduce MACE 20% vs. GMT. The primary outcomes are first occurrence of death, MI, Stroke/TIA, Hospitalization for chest pain or heart failure . Secondary outcomes include quality of life, health resource consumption, angina, CV death and primary outcome components. Follow-up will be 3-years using 50 sites: primarily VA and Active Duty Military Hospitals/Clinics and a PCORnet clinical data research network (OneFlorida Consortium).

Eligibility: Enrolled women will be clinically stable, with angina or equivalent symptoms of sufficient severity to seek, or have sought, referral for coronary angiography or coronary CT angiogram within the previous 2 years

Inclusion Criteria: 

  • Signs and symptoms of suspected ischemia prompting referral for further evaluation by cardiac catheterization or coronary CT angiogram.
  • Willing to provide written informed consent.
  • Age ≥18 yrs.
  • Non-obstructive CAD defined as <50% diameter reduction of a major epicardial vessel on invasive angiography within 2 yrs.

Exclusion Criteria: 

  • History of noncompliance (with medical therapy, protocol, or follow-up).
  • History of non-ischemic dilated or hypertrophic cardiomyopathy.
  • Documented ACS within previous 30 days.
  • LVEF <40%, NYHA HF class III-IV, or hospitalization for HFrEF within 180 days.
  • Stroke within previous 180 ds. or intracranial hemorrhage at any time.
  • End-stage renal disease, on dialysis, or estimated glomerular filtration rate (eGFR) <30 ml/min.
  • Severe valvular disease or likely to require surgery/TVAR within 5 yrs.
  • Life expectancy <3-yrs. due to non-cardiovascular comorbidity.
  • Enrolled in a competing clinical trial.
  • Prior intolerance to both an ACE-I and ARB.
  • Pregnancy (all pre-menopausal females must have negative serum pregnancy test).

OneFlorida Partner Sites

Orlando Health
Florida Hospital
Florida Hospital

OneFlorida Partners

  • Orlando Health
  • Florida Hospital

Published Papers and Presentations

  • Coming Soon

Contact Information

For more information, please contact Trinity Cromwell at (352) 273-7535 or

Page Last Updated: November 7, 2017

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