TCT-605 Different Clinical and Angiographic Characteristics according to Vessel Size in Patients undergoing Acetylcholine Provocation Test
- 1 Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea, Republic of
- 2 Cardiology Department, Eulji University, Eulji General Hospital, Seoul, Korea, Republic of
Background
There are limited data regarding angiographic and clinical characteristics according to different reference vessel size during intracoronary acetylcholine (Ach) provocation test to evaluate coronary artery spasm (CAS) in patients (pts) with suspected vasospastic angina.
Methods
A total 2021 consecutive pts, who underwent intracoronary Ach provocation test were enrolled. Provocation test was performed by incremental dosages (20, 50, 100ug) of Ach until get significant response (>70% narrowing). The study population were divided into small vessel group (<2.5mm) and large vessel group (≧2.5mm) and angiographic and clinical parameters during Ach provocation test were compared between the two groups.
Results
Baseline characteristics were similar between the two groups except that large vessel group had more male gender (56% vs. 47.4, p<0.001), peripheral vascular disease (4.1% vs. 2.3%, p=0.025), alcoholics (39.7% vs. 30.5%, p<0.001) and less diabetics (8.5 vs. 13.9, p<0.001). During Ach provocation test, large vessel group had a higher incidence of baseline spasm (>30%) and multi-vessel spasm, whereas small vessel group had higher incidence myocardial bridge and diffuse spasm (table).
Conclusions
According to the current study, in pts with vasospastic angina, large reference vessel was associated with increase basal spasm and multivessel spasm; whereas small reference vessel was associated with diffuse spasm.
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