TCT-432 Angiographic Characteristics according to Acetylcholine Dose Responsible for Significant Coronary Artery Spasm
- 1 Cardiology, Chungju Kunkuk University, Chungju, Korea, Republic of
- 2 Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea, Republic of
Background
We assume that patients (pt) showing positive acetylcholine (Ach) provocation test to lower Ach dose may more vulnerable to CAS. We investigated whether there are differences in angiographic characteristics according to Ach dose causing significant CAS during intracoronary Ach provocation test.
Methods
A total 1730 consecutive pts underwent Ach provocation test by incremental doses of 20, 50, 100 were enrolled. Significant CAS was defined as focal or diffuse severe transient luminal narrowing (>70%) with/without chest pain or ST-T change on ECG. Angiographic characteristics were compared between the Low dose group (20 & 50 ug, n=716) and High dose group (100 ug, n=1014) among pts with positive Ach provocation test.
Results
Baseline clinical characteristics were similar between the two groups except the Low dose group had more elderly (> 50 years), diabetes mellitus and previous myocardial infarction (MI). During the Ach provocation test, the incidence of atrio-ventricular (AV) block, severe CAS (>70% stenosis by QCA), multi-vessel spasm and diffuse spasm were more frequent in low dose group (Table).
Conclusions
In our study, we found that pts showing significant CAS to lower Ach dose showed more chance to have severe, diffuse and mulitvessel spasm during the test. Special care with intensive medical therapy should be considered who showed significant Ach response to lower Ach dose as compared with those responded to higher Ach dose.
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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