Key result
Intracoronary acetylcholine infusion induced a significantly higher maximal coronary constriction rate in a subset of chest pain syndrome patients (66%) compared to controls (26%), suggesting increased vasoreactivity plays a role in chest pain development.
Why the study?
Does intracoronary acetylcholine infusion identify increased coronary vasoreactivity in patients with chest pain syndrome?
Cross-Sectional (n=45)
No
Does intracoronary acetylcholine infusion identify increased coronary vasoreactivity in patients with chest pain syndrome?
Absolute Event Rate: 66% vs 26%
p-value: p=<0.01
Intracoronary acetylcholine infusion reveals that increased coronary vasoreactivity may play an important role in the development of chest pain in a subset of patients with chest pain syndrome.
Acetylcholine testing may identify vasoreactive chest pain subsets; hypothesis-generating and should not yet change practice.
Coronary vasoreactivity of patients with chest pain syndrome (CPS, 18 patients) was examined with intracoronary acetylcholine infusion test (ACh). For comparison, 10 patients with vasospastic angina (VSA) and 17 patients without chest pain (control group) were used. The luminal diameters of coronary arteries were measured before and after ACh, and the maximal value of constriction rate of each segment (MCR) was used as index of vasoreactivity in each patient. By the ACh test, an average MCR of 42 +/- 23% was observed in CPS, 84 +/- 17% in VSA, and 26 +/- 12% in the control group. In CPS, chest pain was induced by ACh in 7 patients (group I), but was not induced in the other 11 patients (group II). The average MCR of group I (66 +/- 18%) was significantly higher than group II (28 +/- 9%, p less than 0.01) and the control group (p less than 0.01), though lower than VSA (p less than 0.05). These findings suggest that increased coronary vasoreactivity may play an important role in the chest pain development in CPS.
No takes yet. Share an insight, caveat, or question.
Shimizu et al. (1992) conducted a cross-sectional in Chest Pain Syndrome (n=45). Intracoronary acetylcholine infusion test vs. Control group (patients without chest pain) was evaluated on Maximal value of constriction rate (MCR) of coronary arteries (p=<0.01). Intracoronary acetylcholine infusion induced a significantly higher maximal coronary constriction rate in a subset of chest pain syndrome patients (66%) compared to controls (26%), suggesting increased vasoreactivity plays a role in chest pain development.
Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context: