[AHA 2012 Impact of Beta-Blocker on Angiographic and Clinical Parameters During Intracoronary Acetylcholine Provocation Test

Abstract 19012: Impact of Beta-Blocker on Angiographic and Clinical Parameters During Intracoronary Acetylcholine Provocation Test

Sung Il Im; Seung Woon Rha; Byoung Geol Choi; Se Yeon Choi; Sun Won Kim; Jin Oh Na; Seong Woo Han; Cheol Ung Choi; Hong Euy Lim; Jin Won Kim; Eung Ju Kim; Chang Gyu Park; Hong Seog Seo; Dong Joo Oh

Cardiovascular Cntr, Korea Univ Guro Hosp, Seoul, Korea, Republic of

Background: Beta blockers (BB) are widely used to control hypertension. It is well known that BB may lead to significant vasospasm. However, the impact of chronic administration of BB on clinical and angiographic characteristics during acetylcholine (Ach) provocation test is not clarified yet.

Methods: A total 3034 consecutive patients (pts) underwent coronary angiography with Ach provocation test from January 2004 to August 2010 were enrolled for this study. Ach was injected in incremental doses of 20, 50, 100μ g into the left coronary artery. Significant coronary artery spasm (CAS) was defined as focal or diffuse severe transient luminal narrowing (>70%) with/without chest pain or ST-T change on ECG. A total 1394 pts (45.9%) showed positive provocation tests. Among the (+) provocation test pts, we compared the clinical and angiographic characteristics of patients with beta-blocker to those without beta-blocker in pts with myocardial infarction.

Results: The baseline clinical and procedural characteristics are well balanced between the two groups. There was no difference in the incidence of myocardial bridges, chest pain, ischemic ECG changes and atrioventricular (AV) block on ECG, incidence of baseline spasm, severe vasospasm, multi-vessel involvements during the Ach provocation test were similar in both groups

Conclusion: The use of beta blocker in pts with vasospastic angina was not associated with worse clinical and angiographic parameters during the Ach provocation test. BB may be safely used in pts with vasospastic angina.

Author Disclosures: S. Im: None. S. Rha: None. B. Choi: None. S. Choi: None.S. Kim: None. J. Na: None. S. Han: None. C. Choi: None. H. Lim: None. J. Kim: None. E. Kim: None. C. Park: None. H. Seo: None. D. Oh: None.

Key Words: Coronary vasospasm • Beta-blocker