Multivessel versus single vessel spasm, as assessed by the intracoronary acetylcholine provocation test, in Korean patients

Ji Young Park, Seung-Woon Rha, Zhe Jin, Kanhaiya L. Poddar, Sureshkumar Ramasamy, Kang Yin Chen, Yong Jian Li, Byoung Geol Choi, Sung Kee Ryu, Jae Woong Choi, Eun Ju Song, Ji Won Ryou, Amro Elnagar, Yun Kyung Kim, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu ParkHong Seog Seo, Dong Joo Oh

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

1. Coronary artery spasm (CAS) is known to be a major cause of myocardial ischaemia. Multivessel coronary spasm (MVS) in particular is likely to induce more severe and prolonged myocardial ischaemia than single vessel spasm (SVS). 2. In the present study, a total of 1082 consecutive patients without significant coronary artery disease who underwent an acetylcholine (ACh) provocation test between March 2004 and April 2009 were investigated. Patients were divided into three groups: an MVS group (n=275), an SVS group (n=376) and a non-CAS group (n=431). Differences in clinical and angiographic characteristics following the ACh provocation test were evaluated between the MVS, SVS and non-CAS groups. 3. At baseline, patients in the MVS group had the highest prevalence of peripheral artery disease (PAD), hyperlipidaemia, smoking and old age, as well as the highest triglyceride levels. Calcium channel blockers were most frequently prescribed in MVS patients before the ACh test. During the ACh test, the highest prevalence of chest pain, ischaemic electrocardiogram changes, baseline spasms and diffuse and severe spasms were observed in the MVS group. The response rate to lower ACh doses that induce CAS was also higher in the MVS group. Multivariate analysis showed that the presence of PAD (odds ratio (OR) 2.0; P=0.006) and baseline spasm (OR 1.4; P=0.045) were independent predictors of ACh-induced MVS. 4. In conclusion, ischaemic symptoms, diffuse and severe spasm and baseline spasm were more frequently associated with MVS patients, suggesting more intensive medical therapies and close clinical follow up would be required for this patient group.

Original languageEnglish
Pages (from-to)819-823
Number of pages5
JournalClinical and Experimental Pharmacology and Physiology
Volume38
Issue number12
DOIs
Publication statusPublished - 2011 Dec 1

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Spasm
Acetylcholine
Peripheral Arterial Disease
Myocardial Ischemia
Coronary Vessels
Arteries
Odds Ratio

Keywords

  • Acetylcholine
  • Multivessel coronary artery spasm

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)
  • Pharmacology

Cite this

Multivessel versus single vessel spasm, as assessed by the intracoronary acetylcholine provocation test, in Korean patients. / Park, Ji Young; Rha, Seung-Woon; Jin, Zhe; Poddar, Kanhaiya L.; Ramasamy, Sureshkumar; Chen, Kang Yin; Li, Yong Jian; Choi, Byoung Geol; Ryu, Sung Kee; Choi, Jae Woong; Song, Eun Ju; Ryou, Ji Won; Elnagar, Amro; Kim, Yun Kyung; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Jin Won; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo.

In: Clinical and Experimental Pharmacology and Physiology, Vol. 38, No. 12, 01.12.2011, p. 819-823.

Research output: Contribution to journalArticle

Park, Ji Young ; Rha, Seung-Woon ; Jin, Zhe ; Poddar, Kanhaiya L. ; Ramasamy, Sureshkumar ; Chen, Kang Yin ; Li, Yong Jian ; Choi, Byoung Geol ; Ryu, Sung Kee ; Choi, Jae Woong ; Song, Eun Ju ; Ryou, Ji Won ; Elnagar, Amro ; Kim, Yun Kyung ; Na, Jin Oh ; Choi, Cheol Ung ; Lim, Hong Euy ; Kim, Jin Won ; Kim, Eung Ju ; Park, Chang Gyu ; Seo, Hong Seog ; Oh, Dong Joo. / Multivessel versus single vessel spasm, as assessed by the intracoronary acetylcholine provocation test, in Korean patients. In: Clinical and Experimental Pharmacology and Physiology. 2011 ; Vol. 38, No. 12. pp. 819-823.
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AU - Park, Ji Young

AU - Rha, Seung-Woon

AU - Jin, Zhe

AU - Poddar, Kanhaiya L.

AU - Ramasamy, Sureshkumar

AU - Chen, Kang Yin

AU - Li, Yong Jian

AU - Choi, Byoung Geol

AU - Ryu, Sung Kee

AU - Choi, Jae Woong

AU - Song, Eun Ju

AU - Ryou, Ji Won

AU - Elnagar, Amro

AU - Kim, Yun Kyung

AU - Na, Jin Oh

AU - Choi, Cheol Ung

AU - Lim, Hong Euy

AU - Kim, Jin Won

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AU - Seo, Hong Seog

AU - Oh, Dong Joo

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N2 - 1. Coronary artery spasm (CAS) is known to be a major cause of myocardial ischaemia. Multivessel coronary spasm (MVS) in particular is likely to induce more severe and prolonged myocardial ischaemia than single vessel spasm (SVS). 2. In the present study, a total of 1082 consecutive patients without significant coronary artery disease who underwent an acetylcholine (ACh) provocation test between March 2004 and April 2009 were investigated. Patients were divided into three groups: an MVS group (n=275), an SVS group (n=376) and a non-CAS group (n=431). Differences in clinical and angiographic characteristics following the ACh provocation test were evaluated between the MVS, SVS and non-CAS groups. 3. At baseline, patients in the MVS group had the highest prevalence of peripheral artery disease (PAD), hyperlipidaemia, smoking and old age, as well as the highest triglyceride levels. Calcium channel blockers were most frequently prescribed in MVS patients before the ACh test. During the ACh test, the highest prevalence of chest pain, ischaemic electrocardiogram changes, baseline spasms and diffuse and severe spasms were observed in the MVS group. The response rate to lower ACh doses that induce CAS was also higher in the MVS group. Multivariate analysis showed that the presence of PAD (odds ratio (OR) 2.0; P=0.006) and baseline spasm (OR 1.4; P=0.045) were independent predictors of ACh-induced MVS. 4. In conclusion, ischaemic symptoms, diffuse and severe spasm and baseline spasm were more frequently associated with MVS patients, suggesting more intensive medical therapies and close clinical follow up would be required for this patient group.

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