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Effects of radial artery spasm prophylaxis on intracoronary vasomotor responses during acetylcholine spasm provocation testing

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dc.contributor.authorSchäufele, Tim
dc.contributor.authorMenezes, Miguel Nobre
dc.contributor.authorSchulte Steinberg, Benedict
dc.contributor.authorHubert, Astrid
dc.contributor.authorMartínez Pereyra, Valeria
dc.contributor.authorArndt, Helene
dc.contributor.authorSechtem, Udo
dc.contributor.authorBekeredjian, Raffi
dc.contributor.authorOng, Peter
dc.date.accessioned2024-11-28T14:05:32Z
dc.date.available2024-11-28T14:05:32Z
dc.date.issued2025
dc.description© 2024 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.pt_PT
dc.description.abstractBackground: Invasive coronary angiography via the radial approach is commonly performed following radial artery spasm prophylaxis (RASP). It is however unknown, whether RASP influences the results of coronary spasm provocation testing performed after diagnostic angiography. We aimed to investigate the effects of RASP on vasomotor responses during intracoronary acetylcholine (ACh) testing. Methods: We retrospectively screened 372 consecutive patients (51 % female, mean age 61 ± 11 years) with angina and non-obstructive coronary arteries, who underwent intracoronary provocation with ACh according to a standardized protocol. During testing, dose-dependent clinical discomfort and concomitant ischemic electrocardiographic changes were recorded in addition to visual reductions of epicardial lumen diameters. Of these patients, 156 (42 %) received RASP (i.e. 200 μg nitroglycerin and 2.5 mg verapamil), while no RASP was administered in 216 (58 %) patients. Both groups were compared regarding age, sex, cardiovascular risk factors and ACh-test results. Results: ACh provocation testing revealed a pathological test result in 71 patients (46 %) with RASP and 103 patients (48 %) without (p = 0.752) [epicardial spasm: in 20 patients (28 %) with RASP and 42 patients (41 %) without (p = 0.120); microvascular spasm: in 51 patients (72 %) with RASP and 61 patients (59 %) without (p = 0.362)]. Overall, RASP did not significantly alter coronary artery vasomotor responses, neither regarding the frequency (p = 0.752) or type of coronary spasm (microvascular vs. epicardial; p = 0.108) nor regarding the ACh dose leading to spasm (p = 0.151). Conclusions: RASP does not significantly affect coronary vasomotor responses to ACh, suggesting that radial artery spasm prophylaxis can be routinely administered even in patients in whom intracoronary spasm testing is performed.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationInt J Cardiol . 2024 Nov 2:419:132703pt_PT
dc.identifier.doi10.1016/j.ijcard.2024.132703pt_PT
dc.identifier.eissn1874-1754
dc.identifier.issn0167-5273
dc.identifier.urihttp://hdl.handle.net/10400.5/95732
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/international-journal-of-cardiologypt_PT
dc.subjectAngina with non-obstructive coronary arteriespt_PT
dc.subjectCoronary artery spasmpt_PT
dc.subjectIntracoronary acetylcholine provocation testingpt_PT
dc.subjectRadial artery spasm prophylaxispt_PT
dc.titleEffects of radial artery spasm prophylaxis on intracoronary vasomotor responses during acetylcholine spasm provocation testingpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleInternational Journal of Cardiologypt_PT
oaire.citation.volume419pt_PT
person.familyNameNobre Menezes
person.givenNameMiguel
person.identifier.ciencia-id681B-AE69-2857
person.identifier.orcid0000-0001-8363-0363
person.identifier.scopus-author-id56584744400
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationd862cc36-eff7-49c3-bcf9-f63a53ad5f2f
relation.isAuthorOfPublication.latestForDiscoveryd862cc36-eff7-49c3-bcf9-f63a53ad5f2f

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