TCT-310 Impact of Ischemic EKG Changes during the Acetylcholine Provocation Test on 12-month Clinical Outcomes in Patients with Vasospastic Angina

• Sung Il Im¹, 
• Seung-Woon Rha¹, 
• Byoung Geol Choi¹, 
• Se Yeon Choi¹, 
• Yoonjee Park¹, 
• Raghavender Goud Akkala¹, 
• Sunki Lee¹, 
• Ji Bak Kim¹, 
• Jin oh Na¹, 
• Cheol Ung Choi¹, 
• Hong Euy Lim¹, 
• Jin Won Kim¹, 
• Eung Ju Kim¹, 
• Chang Gyu Park¹, 
• Hong Seog Seo¹, 
• Dong Joo Oh¹

• ¹ Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea, Republic of

Background

Clinical significance and angiographic characteristics of patients (pts) with ischemic EKG changes during the Ach provocation test are not clarified yet as compared with pts without EKG change.

Methods

A total 3034 consecutive pts underwent coronary angiography with Ach provocation tests were enrolled. EKG changes were defined as ST segment depression or elevation (>1mm) and T inversion with/without chest pain. We compared the clinical and angiographic characteristics of patients with EKG changes to those without EKG changes.

Results

The baseline clinical and procedural characteristics are well balanced between the two groups. EKG change group showed more frequent chest pain, higher incidence of baseline spasm, severe vasospasm, multi-vessels involvements, and more diffuse spasms (>30mm) than those without EKG changes (Table.1). At 12 months, the incidence of mortality and myocardial infarction were higher in the EKG change group. There was a trend toward higher incidence of target vessel revascularization (TVR)-major adverse cardiac events (MACE) in the EKG change group (Table 2).

Conclusions

The pts with EKG changes during the Ach provocation tests were associated with more frequent chest pain, baseline spasm, diffuse, severe and multivessel spasm than pts without EKG changes, suggesting more intensive medical therapy with close clinical follow up will be required.