Abstract 13479: Predictors Associated With Ischemic ECG Changes During Acetylcholine Provocation Test; Is Uric Acid can be an Useful Biomarker for Significant Coronary Endothelial Dysfunction?
Background: The ischemic electrocardiography (ECG) changes during acetylcholine (Ach) provocation test may reflect more severe coronary artery spasm (CAS). However, predictors associated with the ischemic ECG changes combined with positive Ach provocation test have not studied yet.
Methods: A total 1337 consecutive patients (pts) without significant coronary artery disease who underwent the intracoronary Ach provocation test were enrolled. Ischemic ECG changes were defined as transient reversible ST elevation, ST depression, and T wave inversion during the Ach provocation test. Positive result was defined as visible narrowing > 70%. The association between ischemic ECG changes and possible variables was evaluated.
Results: In the 159 of 1337 (11.9%) pts, ischemic ECG changes were observed during Ach provocation test. In multivariate logistic regression, uric acid level, dyslipidemia, and current alcoholics were independent predictors of ischemic ECG changes (table). Although unadjusted, pts with ischemic ECG changes had higher incidence of 1-year adverse clinical outcomes including recurrent ischemic chest pain, cardiac death and myocardial infarction as compared pts without ischemic ECG changes (6.0% vs. 2.8%, p-value= 0.041).
Conclusion: In this study, serum uric acid level, dysplipidemia and current alcoholics were independent predictors of the ischemic ECG changes combined with positive Ach test. Ischemic ECG changes were associated with more adverse clinical outcomes.
- © 2013 by American Heart Association, Inc.