Which Coronary Artery Should Be Preferred for Starting the Coronary Spasm Provocation Test?
coronary spasm
multivessel spasm
spasm provocation test
vasospastic angina
Journal
Life (Basel, Switzerland)
ISSN: 2075-1729
Titre abrégé: Life (Basel)
Pays: Switzerland
ID NLM: 101580444
Informations de publication
Date de publication:
17 Oct 2023
17 Oct 2023
Historique:
received:
14
09
2023
revised:
14
10
2023
accepted:
14
10
2023
medline:
28
10
2023
pubmed:
28
10
2023
entrez:
28
10
2023
Statut:
epublish
Résumé
The spasm provocation test (SPT) is a critical test for diagnosing vasospastic angina (VSA). However, the choice of vessel to be preferred for initiating the SPT-the right coronary artery (RCA) or the left coronary artery (LCA)-is unclear. This study aimed to assess SPT results including SPT-related complications while initiating the SPT in the RCA and LCA. We enrolled 225 patients who underwent coronary angiography and SPTs. The SPT was first performed in the RCA in 133 patients (RCA group) and the LCA in 92 patients (LCA group). We defined VSA as >90% narrowing of the coronary artery during the SPT, accompanied by chest pain and/or ST-T changes on the electrocardiogram. When coronary spasm occurs in two or more major coronary arteries, it is referred to as a multivessel spasm (MVS). SPT-related complications comprised atrial fibrillation, ventricular fibrillation, and unstable hemodynamics following catecholamine use. Analyses using propensity score matching (PSM) were performed in 120 patients. No significant differences in the frequencies of VSA and complications were observed between the two groups (RCA: 79% and 19%, respectively; LCA: 85% and 22%, respectively). In both groups, spasms were most frequently provoked in the left anterior descending coronary artery (both Although the diagnostic rate of VSA and frequency of SPT-related complications were similar in the two groups, the frequency of MVS was higher in the LCA group than in the RCA group because of the increase in the number of LCX spasms. A routine SPT may be started from the LCA.
Sections du résumé
BACKGROUND
BACKGROUND
The spasm provocation test (SPT) is a critical test for diagnosing vasospastic angina (VSA). However, the choice of vessel to be preferred for initiating the SPT-the right coronary artery (RCA) or the left coronary artery (LCA)-is unclear. This study aimed to assess SPT results including SPT-related complications while initiating the SPT in the RCA and LCA.
METHODS
METHODS
We enrolled 225 patients who underwent coronary angiography and SPTs. The SPT was first performed in the RCA in 133 patients (RCA group) and the LCA in 92 patients (LCA group). We defined VSA as >90% narrowing of the coronary artery during the SPT, accompanied by chest pain and/or ST-T changes on the electrocardiogram. When coronary spasm occurs in two or more major coronary arteries, it is referred to as a multivessel spasm (MVS). SPT-related complications comprised atrial fibrillation, ventricular fibrillation, and unstable hemodynamics following catecholamine use. Analyses using propensity score matching (PSM) were performed in 120 patients.
RESULTS
RESULTS
No significant differences in the frequencies of VSA and complications were observed between the two groups (RCA: 79% and 19%, respectively; LCA: 85% and 22%, respectively). In both groups, spasms were most frequently provoked in the left anterior descending coronary artery (both
CONCLUSIONS
CONCLUSIONS
Although the diagnostic rate of VSA and frequency of SPT-related complications were similar in the two groups, the frequency of MVS was higher in the LCA group than in the RCA group because of the increase in the number of LCX spasms. A routine SPT may be started from the LCA.
Identifiants
pubmed: 37895453
pii: life13102072
doi: 10.3390/life13102072
pmc: PMC10608489
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
World J Cardiol. 2021 Sep 26;13(9):456-463
pubmed: 34621490
J Cardiovasc Dev Dis. 2022 Jun 28;9(7):
pubmed: 35877566
JACC Cardiovasc Imaging. 2020 Sep;13(9):1875-1887
pubmed: 32417336
Clin Cardiol. 2015 Mar;38(3):171-7
pubmed: 25693967
J Am Coll Cardiol. 2022 Jun 21;79(24):2367-2378
pubmed: 35710187
Heart Vessels. 2018 Feb;33(2):126-133
pubmed: 28905210
Eur Heart J. 2020 Oct 1;41(37):3504-3520
pubmed: 32626906
Heart Vessels. 2015 Nov;30(6):771-8
pubmed: 25179297
Diagnostics (Basel). 2021 Sep 07;11(9):
pubmed: 34573973
J Clin Med. 2023 May 29;12(11):
pubmed: 37297948
J Am Heart Assoc. 2013 Jul 15;2(4):e000227
pubmed: 23858100
J Am Heart Assoc. 2016 May 20;5(5):
pubmed: 27207970
J Cardiol. 2018 Sep;72(3):200-207
pubmed: 29898865
Heart Vessels. 2019 Oct;34(10):1631-1638
pubmed: 30993440
J Cardiol. 2008 Feb;51(1):2-17
pubmed: 18522770
Acta Cardiol. 2021 Feb;76(1):38-45
pubmed: 31707937
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
Cardiovasc Interv Ther. 2021 Jan;36(1):39-51
pubmed: 33108592
Int J Cardiol. 2018 Oct 15;269:27-30
pubmed: 29980367
Circ J. 2023 May 25;87(6):879-936
pubmed: 36908169
J Am Coll Cardiol. 2013 Sep 24;62(13):1144-53
pubmed: 23916938
J Am Coll Cardiol. 2015 Sep 8;66(10):1105-15
pubmed: 26337988
Life (Basel). 2022 Jul 27;12(8):
pubmed: 36013303
Heart Vessels. 2017 Jun;32(6):685-689
pubmed: 27873006
Circ J. 2014;78(11):2779-801
pubmed: 25273915
Coron Artery Dis. 2016 Jun;27(4):273-6
pubmed: 26901444
Life (Basel). 2022 Oct 08;12(10):
pubmed: 36294995
Heart Vessels. 2017 Jul;32(7):902-908
pubmed: 28005169
Intern Med. 2019 Jan 1;58(1):21-30
pubmed: 30101945
JACC Cardiovasc Interv. 2021 Mar 22;14(6):606-618
pubmed: 33736768
Coron Artery Dis. 2015 Sep;26(6):490-4
pubmed: 25974266
Am J Kidney Dis. 2009 Jun;53(6):982-92
pubmed: 19339088
J Cardiol. 2008 Apr;51(2):131-4
pubmed: 18522786
J Cardiol. 2016 Jul;68(1):1-6
pubmed: 27234219