The impact of high sensitivity C-reactive protein level on coronary artery spasm as assessed by intracoronary acetylcholine provocation test

Ji Young Park, Seung-Woon Rha, Yong Jian Li, Kang Yin Chen, Byoung Geol Choi, Se Yeon Choi, Sung Kee Ryu, Jae Woong Choi, Tae Kyun Kim, Jeong Min Kim, Yoon Suk Bak, Jae Hoon Lee, Sung Il Im, Sun Won Kim, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu ParkHong Seog Seo, Dong Joo Oh

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8 Citations (Scopus)

Abstract

Purpose: High sensitive C-reactive protein (hs CRP) is well known as a strong risk factor of cardiovascular disease (CVD). The aim of this study is to evaluate the impact of elevated hs CRP on coronary artery spasm (CAS) as assessed by intracoronary acetylcholine (ACh) provocation test. Materials and Methods: A total of 1729 consecutive patients without significant CVD who underwent coronary angiography and intracoronary ACh test between November 2004 and August 2010 were analyzed. The patients were divided into five groups according to quintiles of hs CRP levels. Results: At baseline, the prevalence of elderly, hypertension, diabetes mellitus, current smoking, and lipid levels were higher in patients with higher hs CRP. During ACh test, the incidences of significant CAS, ischemic electrocardiography (EKG) change, multivessel, and diffuse CAS were higher in patients with higher hs CRP. Multivariate analysis showed that the old age (OR=1.01, CI; 1.0-1.02, p=0.0226), myocardial bridge (OR=3.34, CI; 2.16-5.17, p<0.001), and highest quintile hs CRP (OR=1.54, CI; 1.12-2.18, p=0.008) were independent predictors of ACh induced CAS. However, there was no difference in clinical outcomes up to 12 months. Conclusion: In conclusion, higher hs CRP was associated with higher incidence of CAS, worse angiographic characteristics and ischemic EKG change, but was not associated with clinical outcomes.

Original languageEnglish
Pages (from-to)1299-1304
Number of pages6
JournalYonsei Medical Journal
Volume54
Issue number6
DOIs
Publication statusPublished - 2013 Oct 31

Keywords

  • Acetylcholine
  • C-reactive protein
  • Coronary artery spasm

ASJC Scopus subject areas

  • Medicine(all)

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    Park, J. Y., Rha, S-W., Li, Y. J., Chen, K. Y., Choi, B. G., Choi, S. Y., Ryu, S. K., Choi, J. W., Kim, T. K., Kim, J. M., Bak, Y. S., Lee, J. H., Im, S. I., Kim, S. W., Na, J. O., Choi, C. U., Lim, H. E., Kim, J. W., Kim, E. J., ... Oh, D. J. (2013). The impact of high sensitivity C-reactive protein level on coronary artery spasm as assessed by intracoronary acetylcholine provocation test. Yonsei Medical Journal, 54(6), 1299-1304. https://doi.org/10.3349/ymj.2013.54.6.1299