This research study is looking for women who have chest pain and are scheduled for a coronary angiogram to determine if coronary artery disease (CAD) is present.

The purpose of this study is to compare the effectiveness of standard medical therapy versus usual care in women with chest pain, coronary endothelial dysfunction and unblocked coronary arteries.  Coronary endothelial dysfunction (CED) is a condition in which the layers of cells around the heart do not function properly and is believed to be a key factor in the development of artherosclerosis (fat deposits in arteries).  In addition, CED is associated with an increased risk for future cardiovascular events, such as heart attack and stroke.

A coronary angiogram allows physicians to see if any of the arteries in the heart are blocked, usually by fatty plaque.  In many instances, angiograms in women experiencing chest pain do not show evidence of coronary disease (free of significant plaque build-up); therefore, these women may not receive appropriate medical treatment.  However, many of these women return to their physicians more than once with chest pain and go through a similar battery of tests.

Endothelial function testing will be performed on women without significant coronary disease in order to help identify women who may be likely to develop CAD and who would benefit from aggressive lifestyle (dietary counseling, exercise) or medical (treatment with aspirin and cholesterol and blood pressure lowering medications) interventions.

Participation in this study will last for about one year and will involove a minimum of four (4) follow-up visits.  All study visits, CMR, and study medications will be provided at no cost to you.