Diabetes mellitus is not a risk factor for coronary artery spasm as assessed by an intracoronary acetylcholine provocation test: Angiographic and clinical characteristics of 986 patients

Yong Jian Li, Myung Han Hyun, Seung Woon Rha, Kang Yin Chen, Zhe Jin, Qun Dang, Chan Mi Park, Ji Eun Lee, Ji Young Park, Cheol Ung Choi, Jin Oh Na, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh

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8 Citations (Scopus)

Abstract

Objectives: Both diabetes mellitus (DM) and coronary artery spasm (CAS) are associated with endothelial dysfunction. Thus, a higher incidence of CAS is expected in diabetic patients (pts). We evaluated the impacts of DM and the status of blood sugar control on CAS with intracoronary acetylcholine (ACh) provocation test. METHODS: A total of 986 pts (106 DM vs 880 non-DM pts) with angiographically normal coronary artery received ACh provocation test. Significant CAS was defined as a transient >90% luminal narrowing with concurrent chest pain and/ or ST-segment changes. HbA1c <7% was considered a controlled blood sugar level. RESULTS: The incidence of CAS was similar between patients with versus without DM (30.2% vs 23.5%; P≤.13). Multivariable analysis showed that DM was not an independent risk factor for significant CAS (odds ratio [OR], 1.29; 95% confidence interval [CI], 0.81-2.07; P≤.28). The angiographic characteristics of CAS were also similar between these two groups. Subgroup analysis regarding the impact of the status of blood sugar control on CAS showed that the incidence of CAS was similar between diabetic pts with versus without controlled blood sugar levels (35.4% vs 25.9%; P≤.29). Multivariable analysis showed that the uncontrolled blood sugar level was not an independent risk factor for CAS (OR, 0.79; 95% CI, 0.29-2.13; P≤.64). CONCLUSIONS: Despite the expected endothelial dysfunction, DM and the status of blood sugar control are not associated with CAS, suggesting the existence of different mechanisms for CAS and coronary artery disease.

Original languageEnglish
Pages (from-to)234-239
Number of pages6
JournalJournal of Invasive Cardiology
Volume26
Issue number6
Publication statusPublished - 2014 Jun

Keywords

  • blood sugar control
  • endothelial dysfunction

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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    Li, Y. J., Hyun, M. H., Rha, S. W., Chen, K. Y., Jin, Z., Dang, Q., Park, C. M., Lee, J. E., Park, J. Y., Choi, C. U., Na, J. O., Lim, H. E., Kim, J. W., Kim, E. J., Park, C. G., Seo, H. S., & Oh, D. J. (2014). Diabetes mellitus is not a risk factor for coronary artery spasm as assessed by an intracoronary acetylcholine provocation test: Angiographic and clinical characteristics of 986 patients. Journal of Invasive Cardiology, 26(6), 234-239.