Impact of alcohol drinking on acetylcholine-induced coronary artery spasm in Korean populations

Sung Min Sohn, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Ahmed Mashaly, Yoonjee Park, Won Young Jang, Woohyeun Kim, Jah Yeon Choi, Eun Jin Park, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh, Seung-Woon Rha

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Abstract

Background and aims Generally, immoderate alcohol consumption is associated with variant angina and accepted as one of the risk factors for coronary artery spasm (CAS), but evidence is lacking in this regard. The aim of this study is to evaluate the impact of alcohol consumption and drinking pattern on CAS by acetylcholine (ACH) provocation test and long-term clinical outcomes. Methods A total of 5491 patients with typical or atypical chest pain, without significant coronary artery disease, who underwent intracoronary ACH provocation test, were enrolled prospectively, and retrospectively analyzed in this study. They were divided into two groups according to their alcohol drinking status; the current alcohol (CA) drinking group (n = 1792), and non-CA group (n = 3699). To adjust for potential confounders, a propensity score matching (PSM) analysis was performed. The primary endpoint was incidence of CAS, and secondary endpoints were major adverse cardiac events (MACE) and recurrent angina requiring repeat coronary angiography (CAG) at 5 years. Results After PSM analysis, alcohol consumption was a strong risk factor for CAS. Furthermore, excessive alcohol consumption was correlated with a higher risk for CAS. As compared with the non-CA group, the CA group showed worse angiographic and clinical findings, including higher incidence of CAS (58% vs. 62%, p = 0.016), spontaneous spasm (17% vs. 22%, p = 0.004), multi-vessel spasm (31% vs. 37%, p = 0.009), proximal epicardial spasm (39% vs. 46%, p = 0.002), ischemic electrocardiography changes such as T-inversion (0.4% vs. 1.2%, p < 0.001) and chest pain (42% vs. 46%, p = 0.047) during ACH provocation test. However, the status and pattern of alcohol drinking had no influence on long-term clinical outcomes such as MACE or recurrent angina. Conclusions Alcohol consumption is a strong risk factor for CAS, and excessive alcohol consumption was correlated with a higher risk for CAS. Further well-designed studies are needed to confirm the results.

Original languageEnglish
Pages (from-to)163-169
Number of pages7
JournalAtherosclerosis
Volume268
DOIs
Publication statusPublished - 2018 Jan 1

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Spasm
Alcohol Drinking
Acetylcholine
Coronary Vessels
Population
Propensity Score
Alcohols
Chest Pain
Incidence
Coronary Angiography
Coronary Artery Disease
Electrocardiography

Keywords

  • Acetylcholine
  • Alcohol
  • Angina
  • Coronary artery spasm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Impact of alcohol drinking on acetylcholine-induced coronary artery spasm in Korean populations. / Sohn, Sung Min; Choi, Byoung Geol; Choi, Se Yeon; Byun, Jae Kyeong; Mashaly, Ahmed; Park, Yoonjee; Jang, Won Young; Kim, Woohyeun; Choi, Jah Yeon; Park, Eun Jin; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo; Rha, Seung-Woon.

In: Atherosclerosis, Vol. 268, 01.01.2018, p. 163-169.

Research output: Contribution to journalArticle

Sohn, SM, Choi, BG, Choi, SY, Byun, JK, Mashaly, A, Park, Y, Jang, WY, Kim, W, Choi, JY, Park, EJ, Na, JO, Choi, CU, Lim, HE, Kim, EJ, Park, CG, Seo, HS, Oh, DJ & Rha, S-W 2018, 'Impact of alcohol drinking on acetylcholine-induced coronary artery spasm in Korean populations', Atherosclerosis, vol. 268, pp. 163-169. https://doi.org/10.1016/j.atherosclerosis.2017.11.032
Sohn, Sung Min ; Choi, Byoung Geol ; Choi, Se Yeon ; Byun, Jae Kyeong ; Mashaly, Ahmed ; Park, Yoonjee ; Jang, Won Young ; Kim, Woohyeun ; Choi, Jah Yeon ; Park, Eun Jin ; Na, Jin Oh ; Choi, Cheol Ung ; Lim, Hong Euy ; Kim, Eung Ju ; Park, Chang Gyu ; Seo, Hong Seog ; Oh, Dong Joo ; Rha, Seung-Woon. / Impact of alcohol drinking on acetylcholine-induced coronary artery spasm in Korean populations. In: Atherosclerosis. 2018 ; Vol. 268. pp. 163-169.
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title = "Impact of alcohol drinking on acetylcholine-induced coronary artery spasm in Korean populations",
abstract = "Background and aims Generally, immoderate alcohol consumption is associated with variant angina and accepted as one of the risk factors for coronary artery spasm (CAS), but evidence is lacking in this regard. The aim of this study is to evaluate the impact of alcohol consumption and drinking pattern on CAS by acetylcholine (ACH) provocation test and long-term clinical outcomes. Methods A total of 5491 patients with typical or atypical chest pain, without significant coronary artery disease, who underwent intracoronary ACH provocation test, were enrolled prospectively, and retrospectively analyzed in this study. They were divided into two groups according to their alcohol drinking status; the current alcohol (CA) drinking group (n = 1792), and non-CA group (n = 3699). To adjust for potential confounders, a propensity score matching (PSM) analysis was performed. The primary endpoint was incidence of CAS, and secondary endpoints were major adverse cardiac events (MACE) and recurrent angina requiring repeat coronary angiography (CAG) at 5 years. Results After PSM analysis, alcohol consumption was a strong risk factor for CAS. Furthermore, excessive alcohol consumption was correlated with a higher risk for CAS. As compared with the non-CA group, the CA group showed worse angiographic and clinical findings, including higher incidence of CAS (58{\%} vs. 62{\%}, p = 0.016), spontaneous spasm (17{\%} vs. 22{\%}, p = 0.004), multi-vessel spasm (31{\%} vs. 37{\%}, p = 0.009), proximal epicardial spasm (39{\%} vs. 46{\%}, p = 0.002), ischemic electrocardiography changes such as T-inversion (0.4{\%} vs. 1.2{\%}, p < 0.001) and chest pain (42{\%} vs. 46{\%}, p = 0.047) during ACH provocation test. However, the status and pattern of alcohol drinking had no influence on long-term clinical outcomes such as MACE or recurrent angina. Conclusions Alcohol consumption is a strong risk factor for CAS, and excessive alcohol consumption was correlated with a higher risk for CAS. Further well-designed studies are needed to confirm the results.",
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author = "Sohn, {Sung Min} and Choi, {Byoung Geol} and Choi, {Se Yeon} and Byun, {Jae Kyeong} and Ahmed Mashaly and Yoonjee Park and Jang, {Won Young} and Woohyeun Kim and Choi, {Jah Yeon} and Park, {Eun Jin} and Na, {Jin Oh} and Choi, {Cheol Ung} and Lim, {Hong Euy} and Kim, {Eung Ju} and Park, {Chang Gyu} and Seo, {Hong Seog} and Oh, {Dong Joo} and Seung-Woon Rha",
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T1 - Impact of alcohol drinking on acetylcholine-induced coronary artery spasm in Korean populations

AU - Sohn, Sung Min

AU - Choi, Byoung Geol

AU - Choi, Se Yeon

AU - Byun, Jae Kyeong

AU - Mashaly, Ahmed

AU - Park, Yoonjee

AU - Jang, Won Young

AU - Kim, Woohyeun

AU - Choi, Jah Yeon

AU - Park, Eun Jin

AU - Na, Jin Oh

AU - Choi, Cheol Ung

AU - Lim, Hong Euy

AU - Kim, Eung Ju

AU - Park, Chang Gyu

AU - Seo, Hong Seog

AU - Oh, Dong Joo

AU - Rha, Seung-Woon

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background and aims Generally, immoderate alcohol consumption is associated with variant angina and accepted as one of the risk factors for coronary artery spasm (CAS), but evidence is lacking in this regard. The aim of this study is to evaluate the impact of alcohol consumption and drinking pattern on CAS by acetylcholine (ACH) provocation test and long-term clinical outcomes. Methods A total of 5491 patients with typical or atypical chest pain, without significant coronary artery disease, who underwent intracoronary ACH provocation test, were enrolled prospectively, and retrospectively analyzed in this study. They were divided into two groups according to their alcohol drinking status; the current alcohol (CA) drinking group (n = 1792), and non-CA group (n = 3699). To adjust for potential confounders, a propensity score matching (PSM) analysis was performed. The primary endpoint was incidence of CAS, and secondary endpoints were major adverse cardiac events (MACE) and recurrent angina requiring repeat coronary angiography (CAG) at 5 years. Results After PSM analysis, alcohol consumption was a strong risk factor for CAS. Furthermore, excessive alcohol consumption was correlated with a higher risk for CAS. As compared with the non-CA group, the CA group showed worse angiographic and clinical findings, including higher incidence of CAS (58% vs. 62%, p = 0.016), spontaneous spasm (17% vs. 22%, p = 0.004), multi-vessel spasm (31% vs. 37%, p = 0.009), proximal epicardial spasm (39% vs. 46%, p = 0.002), ischemic electrocardiography changes such as T-inversion (0.4% vs. 1.2%, p < 0.001) and chest pain (42% vs. 46%, p = 0.047) during ACH provocation test. However, the status and pattern of alcohol drinking had no influence on long-term clinical outcomes such as MACE or recurrent angina. Conclusions Alcohol consumption is a strong risk factor for CAS, and excessive alcohol consumption was correlated with a higher risk for CAS. Further well-designed studies are needed to confirm the results.

AB - Background and aims Generally, immoderate alcohol consumption is associated with variant angina and accepted as one of the risk factors for coronary artery spasm (CAS), but evidence is lacking in this regard. The aim of this study is to evaluate the impact of alcohol consumption and drinking pattern on CAS by acetylcholine (ACH) provocation test and long-term clinical outcomes. Methods A total of 5491 patients with typical or atypical chest pain, without significant coronary artery disease, who underwent intracoronary ACH provocation test, were enrolled prospectively, and retrospectively analyzed in this study. They were divided into two groups according to their alcohol drinking status; the current alcohol (CA) drinking group (n = 1792), and non-CA group (n = 3699). To adjust for potential confounders, a propensity score matching (PSM) analysis was performed. The primary endpoint was incidence of CAS, and secondary endpoints were major adverse cardiac events (MACE) and recurrent angina requiring repeat coronary angiography (CAG) at 5 years. Results After PSM analysis, alcohol consumption was a strong risk factor for CAS. Furthermore, excessive alcohol consumption was correlated with a higher risk for CAS. As compared with the non-CA group, the CA group showed worse angiographic and clinical findings, including higher incidence of CAS (58% vs. 62%, p = 0.016), spontaneous spasm (17% vs. 22%, p = 0.004), multi-vessel spasm (31% vs. 37%, p = 0.009), proximal epicardial spasm (39% vs. 46%, p = 0.002), ischemic electrocardiography changes such as T-inversion (0.4% vs. 1.2%, p < 0.001) and chest pain (42% vs. 46%, p = 0.047) during ACH provocation test. However, the status and pattern of alcohol drinking had no influence on long-term clinical outcomes such as MACE or recurrent angina. Conclusions Alcohol consumption is a strong risk factor for CAS, and excessive alcohol consumption was correlated with a higher risk for CAS. Further well-designed studies are needed to confirm the results.

KW - Acetylcholine

KW - Alcohol

KW - Angina

KW - Coronary artery spasm

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