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

Research output: Contribution to journalArticle

5 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 Jan 1

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Spasm
Acetylcholine
Coronary Vessels
Diabetes Mellitus
Blood Glucose
Incidence
Odds Ratio
Confidence Intervals
Chest Pain
Coronary Artery Disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

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

In: Journal of Invasive Cardiology, Vol. 26, No. 6, 01.01.2014, p. 234-239.

Research output: Contribution to journalArticle

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title = "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",
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.",
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T1 - Diabetes mellitus is not a risk factor for coronary artery spasm as assessed by an intracoronary acetylcholine provocation test

T2 - Angiographic and clinical characteristics of 986 patients

AU - Li, Yong Jian

AU - Hyun, Myung Han

AU - Rha, Seung-Woon

AU - Chen, Kang Yin

AU - Jin, Zhe

AU - Dang, Qun

AU - Park, Chan Mi

AU - Lee, Ji Eun

AU - Park, Ji Young

AU - Choi, Cheol Ung

AU - Na, Jin Oh

AU - Lim, Hong Euy

AU - Kim, Jin Won

AU - Kim, Eung Ju

AU - Park, Chang Gyu

AU - Seo, Hong Seog

AU - Oh, Dong Joo

PY - 2014/1/1

Y1 - 2014/1/1

N2 - 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.

AB - 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.

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