Five-year major clinical outcomes according to severity of coronary artery spasm as assessed by intracoronary acetylcholine provocation test
- Authors
- Kim, Yong Hoon; Her, Ae-Young; Rha, Seung-Woon; Choi, Byoung Geol; Shim, Minsuk; Choi, Se Yeon; Byun, Jae Kyeong; Li, Hu; Kim, Woohyeun; Kang, Jun Hyuk; Choi, Jah Yeon; Park, Eun Jin; Park, Sung Hun; Lee, Sunki; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo
- Issue Date
- Mar-2018
- Publisher
- ELSEVIER MASSON, CORPORATION OFFICE
- Keywords
- Coronary artery spasm; Acetylcholine; Clinical outcomes
- Citation
- ARCHIVES OF CARDIOVASCULAR DISEASES, v.111, no.3, pp.144 - 154
- Indexed
- SCIE
SCOPUS
- Journal Title
- ARCHIVES OF CARDIOVASCULAR DISEASES
- Volume
- 111
- Number
- 3
- Start Page
- 144
- End Page
- 154
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/76863
- DOI
- 10.1016/j.acvd.2017.05.008
- ISSN
- 1875-2136
- Abstract
- Background. - Long-term clinical outcome data according to severity of coronary artery spasm (CAS) as assessed by an intracoronary acetylcholine provocation test are limited in series of Asian patients. Aim. - To investigate 5-year clinical outcomes in patients with CAS according to CAS severity. Methods. - In total, 5873 consecutive patients with insignificant coronary artery disease (< 70% fixed stenosis) who underwent an acetylcholine provocation test were enrolled and divided into four groups according to CAS severity during the acetylcholine provocation test: negative, borderline positive, moderately positive and severely positive. CAS severity was assessed by quantitative coronary angiography. We investigated 5-year clinical outcomes according to CAS severity. Results. - Over a follow-up period of up to 5 years, before adjustment, the severely-positive CAS group showed a significantly higher incidence of major adverse cardiac events (MACE; composite of death, myocardial infarction and de novo revascularization) (hazard ratio [HR]: 1.834, 95% confidence interval [CI]: 1.047-3.211; P=0.033), total death (HR: 3.124, 95% CI: 1.047-9.322; P=0.041), myocardial infarction (HR: 3.190, 95% CI: 1.069-9.519; P=0.037) and recurrent angina (HR: 1.762, 95% CI: 1.363-2.278; P< 0.001) compared with the negative group. However, after adjustment for baseline confounders, only the incidence of recurrent angina (HR: 1.323, 95% CI: 1.014-1.726; P= 0.039) was significantly higher in the severely-positive CAS group compared with the negative group. Conclusions. - The severity of CAS in the positive group was not associated with an increased incidence of MACE after adjustment for covariates compared with the negative group, but the severely -positive CAS group was associated with a higher incidence of recurrent angina compared with the negative group. (C) 2017 Elsevier Masson SAS. All rights reserved.
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Collections - Graduate School > Department of Biomedical Sciences > 1. Journal Articles
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