Safety assessment and results of coronary spasm provocation testing in patients with myocardial infarction with unobstructed coronary arteries compared to patients with stable angina and unobstructed coronary arteries.

Acetylcholine coronary spasm myocardial infarction with unobstructed coronary arteries safety stable angina

Journal

European heart journal. Acute cardiovascular care
ISSN: 2048-8734
Titre abrégé: Eur Heart J Acute Cardiovasc Care
Pays: England
ID NLM: 101591369

Informations de publication

Date de publication:
08 Jun 2020
Historique:
entrez: 9 6 2020
pubmed: 9 6 2020
medline: 9 6 2020
Statut: aheadofprint

Résumé

Coronary spasm is an established cause for myocardial infarction with unobstructed coronary arteries, and can be diagnosed using intracoronary acetylcholine testing. However, it has been questioned whether such testing is feasible and safe in the acute phase. The aim of this study was to assess the frequency of coronary spasm and the safety of the acetylcholine test in patients with myocardial infarction with unobstructed coronary arteries compared to patients with stable angina and unobstructed coronaries. One hundred and eighty selected patients (52% women, mean age 62±13 years) with either myocardial infarction with unobstructed coronary arteries ( Overall, epicardial spasm was found in 26% with a higher prevalence among the myocardial infarction with unobstructed coronary arteries compared to the stable angina patients (35% vs 19%, Coronary spasm is a frequent cause for myocardial infarction with unobstructed coronary arteries. Spasm provocation testing using acetylcholine is feasible in such patients in the acute phase. The complication rate during acetylcholine testing in myocardial infarction with unobstructed coronary arteries patients is low and comparable to patients with stable angina.

Sections du résumé

BACKGROUND BACKGROUND
Coronary spasm is an established cause for myocardial infarction with unobstructed coronary arteries, and can be diagnosed using intracoronary acetylcholine testing. However, it has been questioned whether such testing is feasible and safe in the acute phase. The aim of this study was to assess the frequency of coronary spasm and the safety of the acetylcholine test in patients with myocardial infarction with unobstructed coronary arteries compared to patients with stable angina and unobstructed coronaries.
METHODS METHODS
One hundred and eighty selected patients (52% women, mean age 62±13 years) with either myocardial infarction with unobstructed coronary arteries (
RESULTS RESULTS
Overall, epicardial spasm was found in 26% with a higher prevalence among the myocardial infarction with unobstructed coronary arteries compared to the stable angina patients (35% vs 19%,
CONCLUSION CONCLUSIONS
Coronary spasm is a frequent cause for myocardial infarction with unobstructed coronary arteries. Spasm provocation testing using acetylcholine is feasible in such patients in the acute phase. The complication rate during acetylcholine testing in myocardial infarction with unobstructed coronary arteries patients is low and comparable to patients with stable angina.

Identifiants

pubmed: 32508106
doi: 10.1177/2048872620932422
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2048872620932422

Auteurs

Sabine Probst (S)

Department of Cardiology, Robert-Bosch-Krankenhaus, Germany.

Andreas Seitz (A)

Department of Cardiology, Robert-Bosch-Krankenhaus, Germany.

Valeria Martínez Pereyra (V)

Department of Cardiology, Robert-Bosch-Krankenhaus, Germany.

Astrid Hubert (A)

Department of Cardiology, Robert-Bosch-Krankenhaus, Germany.

Alexander Becker (A)

Department of Cardiology, Robert-Bosch-Krankenhaus, Germany.

Klaus Storm (K)

Department of Cardiology, Robert-Bosch-Krankenhaus, Germany.

Raffi Bekeredjian (R)

Department of Cardiology, Robert-Bosch-Krankenhaus, Germany.

Udo Sechtem (U)

Department of Cardiology, Robert-Bosch-Krankenhaus, Germany.

Peter Ong (P)

Department of Cardiology, Robert-Bosch-Krankenhaus, Germany.

Classifications MeSH