Acetylcholine Use in Modern Cardiac Catheterization Laboratories: A Systematic Review.
acetylcholine provocation test
coronary spasm
diffuse spasm
prognosis
safety
vasospastic angina
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
21 Feb 2022
21 Feb 2022
Historique:
received:
17
01
2022
revised:
09
02
2022
accepted:
18
02
2022
entrez:
25
2
2022
pubmed:
26
2
2022
medline:
26
2
2022
Statut:
epublish
Résumé
The use of acetylcholine for the diagnosis of vasospastic angina is recommended by international guidelines. However, its intracoronary use is still off-label due to the absence of safety studies. We aimed to perform a systematic review of the literature to identify adverse events related to the intracoronary administration of acetylcholine for vasoreactivity testing to fill this gap. We conducted a systematic review of observational studies and randomized controlled trials dealing with the intracoronary administration of acetylcholine. Articles were searched in MEDLINE (PubMed) using the MeSH strategy. Three independent reviewers determined whether the studies met the inclusion and exclusion criteria. A total of 434 articles were selected. Data concerning clinical characteristics, study population, acetylcholine dosage, and adverse effects were retrieved from the articles. Overall, 71,566 patients were included, of which only 382 (0.5%) developed one adverse event, and there were no fatal events reported (0%). Intracoronary administration of acetylcholine in the setting of coronary spasm provocation testing is safe and plays a central role in the evaluation of coronary vasomotion disorders, making it worthy of becoming a part of clinical practice in all cardiac catheterization laboratories.
Sections du résumé
BACKGROUND
BACKGROUND
The use of acetylcholine for the diagnosis of vasospastic angina is recommended by international guidelines. However, its intracoronary use is still off-label due to the absence of safety studies. We aimed to perform a systematic review of the literature to identify adverse events related to the intracoronary administration of acetylcholine for vasoreactivity testing to fill this gap.
METHODS AND RESULTS
RESULTS
We conducted a systematic review of observational studies and randomized controlled trials dealing with the intracoronary administration of acetylcholine. Articles were searched in MEDLINE (PubMed) using the MeSH strategy. Three independent reviewers determined whether the studies met the inclusion and exclusion criteria. A total of 434 articles were selected. Data concerning clinical characteristics, study population, acetylcholine dosage, and adverse effects were retrieved from the articles. Overall, 71,566 patients were included, of which only 382 (0.5%) developed one adverse event, and there were no fatal events reported (0%).
CONCLUSIONS
CONCLUSIONS
Intracoronary administration of acetylcholine in the setting of coronary spasm provocation testing is safe and plays a central role in the evaluation of coronary vasomotion disorders, making it worthy of becoming a part of clinical practice in all cardiac catheterization laboratories.
Identifiants
pubmed: 35207403
pii: jcm11041129
doi: 10.3390/jcm11041129
pmc: PMC8880288
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Références
Eur Heart J. 2017 Sep 1;38(33):2565-2568
pubmed: 26245334
J Cardiol. 2016 Mar;67(3):236-40
pubmed: 26194867
J Am Coll Cardiol. 2012 Jun 19;59(25):2327-37
pubmed: 22503057
Circ J. 2016;80(2):289-98
pubmed: 26686994
J Am Coll Cardiol. 2008 May 6;51(18):1742-8
pubmed: 18452779
JACC Cardiovasc Interv. 2020 Aug 24;13(16):1847-1864
pubmed: 32819476
Heart. 2018 Feb;104(4):284-292
pubmed: 29030424
Circulation. 2014 Dec 23;130(25):e344-426
pubmed: 25249585
Heart Vessels. 2015 Nov;30(6):771-8
pubmed: 25179297
J Am Coll Cardiol. 2018 Dec 11;72(23 Pt A):2841-2855
pubmed: 30266608
N Engl J Med. 1995 Feb 23;332(8):481-7
pubmed: 7830728
Eur Heart J Acute Cardiovasc Care. 2019 Feb;8(1):54-62
pubmed: 29952633
J Am Coll Cardiol. 2009 May 5;53(18):1653-9
pubmed: 19406340
J Am Heart Assoc. 2013 Jul 15;2(4):e000227
pubmed: 23858100
BMJ. 2009 Jul 21;339:b2700
pubmed: 19622552
Circ J. 2010 Sep;74(9):1943-50
pubmed: 20668353
J Am Heart Assoc. 2016 May 20;5(5):
pubmed: 27207970
Coron Artery Dis. 1994 Nov;5(11):881-7
pubmed: 7719520
ANZ J Surg. 2003 Sep;73(9):712-6
pubmed: 12956787
Int J Cardiol. 2017 Oct 1;244:77-83
pubmed: 28622945
Circulation. 1986 Nov;74(5):955-63
pubmed: 3769179
Lancet. 1999 Nov 27;354(9193):1896-900
pubmed: 10584742
J Am Coll Cardiol. 2017 Nov 7;70(19):2349-2358
pubmed: 29096805
Circulation. 1998 Jun 2;97(21):2123-8
pubmed: 9626172
J Am Coll Cardiol. 2001 Feb;37(2):505-9
pubmed: 11216970
Clin Cardiol. 2015 Mar;38(3):171-7
pubmed: 25693967
N Engl J Med. 2000 Feb 17;342(7):454-60
pubmed: 10675425
JAMA. 2000 Apr 19;283(15):2008-12
pubmed: 10789670
J Am Coll Cardiol. 2012 Feb 14;59(7):655-62
pubmed: 22322081
Int J Cardiol. 2018 Feb 1;252:24-30
pubmed: 29249435
Eur Heart J. 2013 Oct;34(38):2949-3003
pubmed: 23996286
Circ J. 2014;78(11):2779-801
pubmed: 25273915
Catheter Cardiovasc Interv. 2013 Sep 1;82(3):E184-91
pubmed: 23359371
Circulation. 2003 Jan 28;107(3):422-8
pubmed: 12551866
Eur Heart J. 2013 Jan;34(4):258-67
pubmed: 22782943
Cardiology. 2020;145(9):543-552
pubmed: 32750696
Eur Heart J. 2009 Jul;30(13):1590-7
pubmed: 19474053
Am J Cardiol. 2000 Feb 1;85(3):391-4, A10
pubmed: 11078314
JACC Cardiovasc Interv. 2018 Aug 27;11(16):1559-1571
pubmed: 29805111
Circ Cardiovasc Interv. 2020 Apr;13(4):e008587
pubmed: 32279562
Intern Med. 1997 Nov;36(11):760-5
pubmed: 9392345
Coron Artery Dis. 1993 Feb;4(2):177-85
pubmed: 8269209