Safety and Usefulness of Intracoronary Acetylcholine 200 μg Into the Left Coronary Artery as Vasoreactivity Testing: Comparisons With Intracoronary Acetylcholine Maximum 100 μg.
Humans
Acetylcholine
/ administration & dosage
Male
Female
Retrospective Studies
Coronary Vessels
/ physiopathology
Coronary Vasospasm
/ physiopathology
Middle Aged
Injections, Intra-Arterial
Vasodilator Agents
/ administration & dosage
Aged
Coronary Angiography
Electrocardiography
Vasoconstriction
/ drug effects
Dose-Response Relationship, Drug
Angina Pectoris
/ physiopathology
Predictive Value of Tests
acetylcholine 100 μg
acetylcholine 200 μg
left coronary artery
safety
usefulness
vasoreactivity testing
Journal
Clinical cardiology
ISSN: 1932-8737
Titre abrégé: Clin Cardiol
Pays: United States
ID NLM: 7903272
Informations de publication
Date de publication:
Oct 2024
Oct 2024
Historique:
revised:
27
07
2024
received:
25
04
2024
accepted:
05
08
2024
medline:
2
10
2024
pubmed:
2
10
2024
entrez:
2
10
2024
Statut:
ppublish
Résumé
We retrospectively analyzed the usefulness and safety of intracoronary acetylcholine (ACh) 200 μg into the left coronary artery (LCA) as vasoreactivity testing compared with intracoronary ACh 100 μg. We recruited 1433 patients who had angina-like chest pain and intracoronary ACh testing in the LCA, including 1234 patients with a maximum ACh 100 μg and 199 patients with a maximum ACh 200 μg. ACh was injected in incremental doses of 20/50/100/200 μg into the LCA. Positive spasm was defined as ≥ 90% stenosis, usual chest pain, and ischemic electrocardiogram (ECG) changes. The incidence of coronary constriction ≥ 90%, usual chest pain, and ischemic ECG changes with a maximum ACh of 100 μg was markedly higher than that with a maximum ACh of 200 μg. The frequency of unusual chest pain in patients with a maximum ACh of 200 μg was higher than that in those with a maximum ACh of 100 μg (13% vs. 3%, p < 0.001). In patients with rest angina, positive spasm of maximum ACh 100 μg was significantly higher than that of maximum ACh 200 μg, whereas there was no difference regarding positive spasm in patients with atypical chest pain between the two ACh doses. Major complications (1.38% vs. 1.51%, p = 0.8565) and the occurrence of paroxysmal atrial fibrillation (1.81% vs. 2.63%, p = 0.6307) during ACh testing in the LCA were not different between the two maximum ACH doses. Intracoronary ACh 200 μg into the LCA is clinically useful and safe for vasoreactivity testing when intracoronary ACh 100 μg dose not provoke spasms.
Substances chimiques
Acetylcholine
N9YNS0M02X
Vasodilator Agents
0
Types de publication
Journal Article
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e70001Subventions
Organisme : The authors received no specific funding for this work.
Informations de copyright
© 2024 The Author(s). Clinical Cardiology published by Wiley Periodicals, LLC.
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