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Impact of low-dose aspirin on coronary artery spasm as assessed by intracoronary acetylcholine provocation test in Korean patients.
MedLine Citation:
PMID:  22770476     Owner:  NLM     Status:  Publisher    
High-dose aspirin has been reported to aggravate coronary artery spasm (CAS). However, it is unknown whether low-dose aspirin (LDA; 100mg) has deleterious impact on CAS. We assessed the impact of LDA on CAS induced by intracoronary acetylcholine (ACh) provocation test. A total of 2789 consecutive patients without significant coronary artery disease who underwent ACh test between November 2004 and March 2010 were enrolled. The patients were divided into two groups: the aspirin group taking LDA before ACh test (n=221) and the no aspirin group not taking aspirin (n=2568). At baseline, the prevalence of old age, diabetes mellitus, hypertension, and hyperlipidemia were higher in the aspirin group. During the ACh test, the incidence of significant CAS, ischemic chest pain, as well as severe and multivessel spasm was higher in the aspirin group. The response rate to lower ACh dose was higher in the aspirin group. Multivariate analysis showed that the previous use of LDA was an independent predictor of CAS (adjusted odds ratio, 1.6, 95% confidence interval, 1.0-2.3; p=0.031). However, it is likely that the association of LDA and CAS that we have observed is not causal but may be hypothesis generating due to significant baseline differences. Further, male gender, old age, lipid-lowering drugs, baseline spasm, and myocardial bridge were independent predictors of CAS. LDA was more frequently associated with CAS and ischemic symptoms, as well as severe and multivessel spasm, suggesting the patients who have received LDA would require more intensive medical therapies and close follow up.
Ji Young Park; Seung-Woon Rha; Kanhaiya L Poddar; Sureshkumar Ramasamy; Kang-Yin Chen; Yong-Jian Li; Byoung Geol Choi; Sung Kee Ryu; Jae Woong Choi; Sang Hyun Park; Songree Park; Amro Elnagar; Sung Il Im; Sun Won Kim; Jin Oh Na; Cheol Ung Choi; Hong Euy Lim; Jin Won Kim; Eung Ju Kim; Seong Woo Han; Chang Gyu Park; Hong Seog Seo; Dong Joo Oh
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-4
Journal Detail:
Title:  Journal of cardiology     Volume:  -     ISSN:  1876-4738     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Cardiovascular Center, Korea University Guro Hospital, Seoul, Republic of Korea; Cardiology Department, Eulji General Hospital, Eulji University, Seoul, Republic of Korea.
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