■尽管指南推荐冠状动脉内乙酰胆碱(ACh)和麦角新碱(ER)激发试验来诊断血管痉挛型心绞痛,在同一导管插入期间序贯(联合)使用两种药物的可行性和安全性尚不清楚.
■在这项研究中,我们调查了冠状动脉内ACh和ER序贯给药用于冠状动脉痉挛激发试验的可行性和安全性.
■该研究包括235名ACh和ER激发试验阳性结果的患者。最初的冠状动脉内ACh给药,然后进行ER给药进行左冠状动脉(LCA)痉挛激发试验。随后,右冠状动脉(RCA)接受ACh和ER序贯给药进行激发试验.该研究的主要结果是序贯冠状动脉内ACh和ER激发测试的安全性,这是根据全因死亡的综合评估的,持续性室性心动过速和纤颤,和心源性休克.
■即使在LCA中冠状动脉内ACh和ER激发试验的序贯结果为阴性的患者,并且仅在RCA中给予ACh,在235例患者中,33例(14.0%)向RCA中额外给予ER激发试验结果为阳性;3例(1.3%)患者在LCA激发试验期间出现不良反应(所有病例均发生心源性休克).我们没有观察到可归因于痉挛激发测试的死亡。
■冠状动脉内ACh和ER的序贯给药与相对较低的主要并发症发生率相关,可能是安全的,并且可能对血管痉挛型心绞痛的诊断有用。
新型冠状动脉痉挛激发试验的安全性和潜在实用性冠状动脉痉挛是缺血性心脏病的一种亚型,有可能导致心脏病发作.尽管指南建议冠状动脉内给药不同的药物,乙酰胆碱(ACH)和麦角新碱(ER),冠状动脉痉挛激发试验,两种药物序贯(联合)使用的可行性和安全性尚不清楚.在本研究中,我们表明,冠状动脉内ACh和ER的序贯给药与相对较低的主要并发症发生率相关,可能是安全的,并且可能对诊断冠状动脉痉挛有用.
UNASSIGNED: Although guidelines recommend intracoronary acetylcholine (ACh) and ergonovine (ER) provocation testing for diagnosis of vasospastic angina, the feasibility and safety of sequential (combined) use of both pharmacological agents during the same catheterization session remain unclear.
UNASSIGNED: In this study, we investigated the feasibility and safety of sequential intracoronary ACh and ER administration for coronary
spasm provocation testing.
UNASSIGNED: The study included 235 patients who showed positive results on ACh and ER provocation testing. Initial intracoronary ACh administration was followed by ER administration for left coronary artery (LCA)
spasm provocation testing. Subsequently, the right coronary artery (RCA) was subjected to sequential ACh and ER administration for provocation testing. The primary outcome of the study was the safety of sequential intracoronary ACh and ER provocation testing, which was assessed based on a composite of all-cause death, sustained ventricular tachycardia and fibrillation, and cardiogenic shock.
UNASSIGNED: Even in patients with negative results on sequential intracoronary ACh and ER provocation testing in the LCA and only ACh administration into the RCA, additional administration of ER into the RCA showed a positive provocation test result in 33 of 235 (14.0%) patients; three (1.3%) patients developed adverse effects (cardiogenic shock occurred in all cases) during LCA provocation testing. We observed no deaths attributable to
spasm provocation testing.
UNASSIGNED: Sequential administration of intracoronary ACh and ER was associated with a relatively low major complication rate and may be safe and potentially useful for diagnosis of vasospastic angina.
Safety and potential usefulness of novel coronary
spasm provocation testing protocolCoronary
spasm represents a subtype of ischemic heart disease, potentially leading to heart attack. Although guidelines recommend intracoronary administration of different pharmacological agents, acetylcholine (ACh) and ergonovine (ER), for coronary
spasm provocation testing, the feasibility and safety of sequential (combined) use of both drugs are unclear. In the present study, we showed that sequential administration of intracoronary ACh and ER was associated with a relatively low major complication rate and may be safe and potentially useful for diagnosis of coronary vasospasm.