2026Coronary artery diseaseHeart failurePrevention2476 patients

WARRIOR

Therapy group: Ischemia with non-obstructive coronary arteries (ANOCA/INOCA) · Therapy: Intensive medical therapy (high-intensity statin, ACEi/ARB and aspirin) vs. usual care

In women with suspected ANOCA/INOCA, intensive medical therapy did not reduce cardiovascular events versus usual care, though the trial was underpowered because of lower-than-planned recruitment.

Published in Open Heart (2026)

Question: Does intensive medical therapy reduce major cardiovascular events in women with suspected ischemia and non-obstructive coronary arteries (ANOCA/INOCA)?
Design: Randomized, prospective trial with blinded outcome evaluation, conducted at 71 sites in the USA and enrolling 2476 women.
Population: Women with angina from suspected ischemia referred for coronary angiography who had no obstructive coronary artery disease. The final population was older (mean age 64 years), with well-controlled blood pressure and LDL cholesterol at baseline and relatively high use of statins and ACEi/ARB.
Intervention: Intensive medical therapy: high-intensity statin, ACE inhibitor or angiotensin receptor blocker, and aspirin.
Control: Usual care.
Primary outcome: Composite of all-cause death, myocardial infarction, stroke/transient ischemic attack, and hospitalization for angina or heart failure (MACE).
Results: At 2.5 years, 421 events occurred (221 in intensive therapy and 200 in usual care), with no difference in the primary outcome (HR 1.13; 95% CI 0.94 to 1.37; P=0.20) or in secondary outcomes. Hospitalizations for angina were the dominant contributor to MACE.
Conclusion: Intensive medical therapy did not improve outcomes in these women, although limited statistical power precludes ruling out a possible benefit.
Why it matters: The trial shows that outcomes in ANOCA/INOCA are driven by chest pain and angina hospitalization, and highlights the need for further research into strategies for this population with a high burden of symptoms, resource use and poor quality of life.

Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.

Generated on October 14, 2026

Sources

Original publication on PubMed (PMID 41932694) ↗Women's IschemiA TRial to Reduce Events In Non-ObstRuctive CAD (WARRIOR): a randomised controlled trial.
Journal article (DOI) ↗
ClinicalTrials.gov record (NCT03417388) ↗

Videos explaining it

WARRIOR Results

AHA · AHAScience ↗9:13Video page

Source: AHAScience · YouTube
Date: 30 Mar 2025
Audio: English
Subtitles: MultilingualYouTube
Audio transl.: Unconfirmed · check ⚙YouTube

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Podcasts explaining it

Ep.209. ACC 2025 - part 3. WARRIOR trial. Coronary artery disease in women.
Prof. J. Drożdż · Kardio-Know-How ↗25 minEpisode page
Source
Prof. J. Drożdż · Apple Podcasts
Date
16 May 2025
Audio
Polish
Translation
TextGoogle Chrome
Audio transl.
None
WARRIOR Trial: Outcomes to Reduce Events in Non-Obstructive Coronary Artery Disease
ACC · ACCEL Lite: Featured ACCEL Interviews on Exciting CV Research ↗11 minEpisode page
Source
ACC · Apple Podcasts
Date
6 May 2025
Audio
English
Translation
TextGoogle Chrome
Audio transl.
None

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