The Effect of Autonomic Function on Coronary Vasomotion
Information source: Korea University
ClinicalTrials.gov processed this data on August 23, 2015 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Coronary Artery Spasm; Autonomic Dysfunction
Phase: N/A
Status: Completed
Sponsored by: Korea University Official(s) and/or principal investigator(s): Hong Seog Seo, MD, Ph., Principal Investigator, Affiliation: Korea University Guro Hospital
Summary
Autonomic nerve function is involved in both blood pressure (BP) regulation and the
pathogenesis of coronary artery spasm (CAS), but few studies have been published about the
relationship between CAS and BP, with the exception of studies that explore hypertension as
a risk factor for CAS. The purpose of this study was to investigate the incidence of CAS and
atrioventricular (AV) block in association with BP level. The investigators will register
consecutive patients who underwent coronary angiography with an acetylcholine (Ach)-induced
provocation test from November 2004 to May 2012. The investigators exclude from the patients
who were taking antihypertensive drugs or who had a documented history of cardiovascular
disease in order to avoid the confounding effects of cardiovascular medications on coronary
vasomotion. CAS is defined as >70% luminal narrowing on Ach provocation and /or concurrent
chest pain. The study population will be divided into quartiles of rising systolic BP and
diastolic BP. The incidence of Ach-induced CAS according to each systolic BP/diastolic BP
quartile will be evaluated.
Clinical Details
Official title: The Association of Acetylcholine-induced Coronary Artery Spasm With the Blood Pressure Level
Study design: Observational Model: Cohort, Time Perspective: Cross-Sectional
Primary outcome: development of significant CAS
Secondary outcome: Transient high-grade AV block
Detailed description:
A total of consecutive patients in the CAS registry of the Cardiovascular Center at Korea
University Guro Hospital and who had resting chest pain without significant coronary lesions
(luminal narrowing <50%) underwent a provocation test with Ach infusion during coronary
angiography from November 2004 to May 2012 will be registerd. Among them, patients with
documented cardiovascular disease and/or any other serious medical condition, such as an
increased serum creatinine level (>2mg/dl), will be excluded. Patients will be excluded due
to incomplete data. The study population will be divided into quartiles based on rising
systolic BP, diastolic BP, and pulse pressure. Each group will be defined as following
criteria: 1) group 1: systolic BP <117mmHg, diastolic BP <69mmHg, and pulse pressure
<42mmHg; 2) group 2: systolic BP 117-130 mmHg, diastolic BP 69-77 mmHg, and pulse pressure
42-51mmHg; 3) group 3: systolic BP 131-141 mmHg, diastolic BP 78-86 mmHg, and pulse pressure
52-61mmHg; and 4) group 4: systolic BP >141 mmHg, diastolic BP >86 mmHg, and pulse
pressure >61mmHg. CAS+Chest Pain means>70% luminal narrowing on Ach provocation test.
and/or concurrent typical chest pain. BP was measured with a noninvasive BP monitoring
device with the patient lying on the angiographic table after a five-minute rest (Patient
monitoring system, NP 30: Philips, Amsterdam, The Netherlands). The first reading was
discarded, and the mean of the next two consecutive readings was used. Next, coronary
angiography was performed. Hypertension is defined as systolic BP ≥140mmHg and/or diastolic
BP ≥90mmHg on at least two consecutive readings in the outpatient clinic. Patients taking
antihypertensive medications are also categorized as hypertensives. Other Risk factors for
CAS examined in this study include hyperlipidemia (total cholesterol level ≥200mg /dl or
current medication with lipid-lowering drugs), diabetes (fasting blood glucose≥126mg /dl,
and/or glycated Hemoglobin A1c level more than 6. 5% or current use of medications), current
smoker (active smoking within the past 12 months), and current alcohol user (at least 1
alcohol drinking a week).
Eligibility
Minimum age: N/A.
Maximum age: N/A.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- patients had resting chest pain without significant coronary lesions (luminal
narrowing <50%) underwent a provocation test with Ach infusion during coronary
angiography.
Exclusion Criteria:
- patients with documented cardiovascular disease and/or any other serious medical
condition, such as an increased serum creatinine level (>2mg/dl), patients with
incomplete data, and patients who had been diagnosed with hypertension or were
currently using antihypertensive medications.
Locations and Contacts
Hong Seog Seo, Seoul 152-703, Korea, Republic of
Korea Institute of Science and Technology, Seoul, Korea, Republic of
Department of Internal Medicine, Division of Cardiology, Sanbon Hospital, Wonkwang University, Gunpo, Gyeonggi-do, Korea, Republic of
Additional Information
Starting date: May 2013
Last updated: August 23, 2013
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