Author + information
- Seung-Hwan Han,
- Min Soo Kim,
- Pyung Chun Oh,
- Soon Young Suh,
- Yae Min Park,
- Kyounghoon Lee,
- Woong Chol Kang,
- Kwan Kon Koh and
- Taehoon Ahn
Background: The rate of undergoing ergonovine provocation test is quite low because it is time consuming with some risks. In real world clinical practice, vasospastic angina (VAS) is assumed by coronary response to nitrate. In this study, we analyzed weather ergonovine provocation test can be replaced by coronary response to nitrate for the detection of VSA.
Methods: A total 174 consecutive patients underwent ergonovine provocation test for the diagnosis of VSA. Coronary artery response to nitrate was defined as percent diameter change after intracoronary nitrate compared with baseline diameter in most changed coronary segment by ergonovine provocation test. Positive diagnosis of VSA was defined as coronary artery spasm (CAS, >70%) with chest pain or ECG change.
Results: Coronary response to ergonovine showed significant but week inverse correlation with coronary response to nitrate (r=-0.20, p=0.009). Patients with VSA (n=13) had a significantly greater coronary response to ergonovine (-87.4±12.3 vs −29.6±22.3 %, p<0.001) but, no difference of coronary response to nitrate (25.5±44.5 vs 17.5±23.9 %, p=0.53) than in no VSA patients. In receiver operating characteristic curve analysis, coronary response to nitrate showed a weak accuracy for the diagnosis of VSA (Fig).
Conclusions: In suspected VSA patients, coronary response to nitrate cannot replace ergonovine provocation test.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Unusual Presentations of ACS
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1297-321
- 2017 American College of Cardiology Foundation