Randomized Trialhigh evidence
Determining the Physiological Threshold for Angina (ORBITA-FIRE): A Double-Blind, Randomized, Placebo-Controlled Study.
Circulation·May 8, 2026·PMID 42100816
Why it mattersCurrent revascularization decisions rely on ischemia-based FFR/RFR cutoffs that do not directly reflect symptom onset. This study provides the first direct evidence that angina thresholds are highly individualized, workload-dependent, and far lower than diagnostic thresholds, challenging the assumption that relieving ischemia equates to symptom relief.
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