| Safety of coronary reactivity testing in women with no obstructive coronary artery disease: results from the NHLBI-sponsored WISE (Women's Ischemia Syndrome Evaluation) study. | |
| | |
MedLine Citation:
|
PMID: 22721660 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: This study evaluated the safety of coronary reactivity testing (CRT) in symptomatic women with evidence of myocardial ischemia and no obstructive coronary artery disease (CAD). BACKGROUND: Microvascular coronary dysfunction (MCD) in women with no obstructive CAD portends an adverse prognosis of a 2.5% annual major adverse cardiovascular event (MACE) rate. The diagnosis of MCD is established by invasive CRT, yet the risk of CRT is unknown. METHODS: The authors evaluated 293 symptomatic women with ischemia and no obstructive CAD, who underwent CRT at 3 experienced centers. Microvascular function was assessed using a Doppler wire and injections of adenosine, acetylcholine, and nitroglycerin into the left coronary artery. CRT-related serious adverse events (SAEs), adverse events (AEs), and follow-up MACE (death, nonfatal myocardial infarction [MI], nonfatal stroke, or hospitalization for heart failure) were recorded. RESULTS: CRT-SAEs occurred in 2 women (0.7%) during the procedure: 1 had coronary artery dissection, and 1 developed MI associated with coronary spasm. CRT-AEs occurred in 2 women (0.7%) and included 1 transient air microembolism and 1 deep venous thrombosis. There was no CRT-related mortality. In the mean follow-up period of 5.4 years, the MACE rate was 8.2%, including 5 deaths (1.7%), 8 nonfatal MIs (2.7%), 8 nonfatal strokes (2.7%), and 11 hospitalizations for heart failure (3.8%). CONCLUSIONS: In women undergoing CRT for suspected MCD, contemporary testing carries a relatively low risk compared with the MACE rate in these women. These results support the use of CRT by experienced operators for establishing definitive diagnosis and assessing prognosis in this at-risk population. (Women's Ischemia Syndrome Evaluation [WISE]; NCT00832702). |
| | |
Authors:
|
Janet Wei; Puja K Mehta; B Delia Johnson; Bruce Samuels; Saibal Kar; R David Anderson; Babak Azarbal; John Petersen; Barry Sharaf; Eileen Handberg; Chrisandra Shufelt; Kamlesh Kothawade; George Sopko; Amir Lerman; Leslee Shaw; Sheryl F Kelsey; Carl J Pepine; C Noel Bairey Merz |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Research Support, N.I.H., Extramural |
Journal Detail:
|
Title: JACC. Cardiovascular interventions Volume: 5 ISSN: 1876-7605 ISO Abbreviation: JACC Cardiovasc Interv Publication Date: 2012 Jun |
Date Detail:
|
Created Date: 2012-06-22 Completed Date: 2012-10-29 Revised Date: 2013-04-16 |
Medline Journal Info:
|
Nlm Unique ID: 101467004 Medline TA: JACC Cardiovasc Interv Country: United States |
Other Details:
|
Languages: eng Pagination: 646-53 Citation Subset: IM |
Copyright Information:
|
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Division of Cardiology, Women's Heart Center, Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA. |
| Data Bank Information | |
Bank Name/Acc. No.:
|
ClinicalTrials.gov/NCT00832702 |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Acetylcholine
/
diagnostic use Adenosine / diagnostic use Adult Blood Flow Velocity Coronary Angiography* / adverse effects Coronary Circulation* Coronary Vessels / physiopathology* Female Heart Failure / etiology, mortality, physiopathology Hospitalization Humans Laser-Doppler Flowmetry* Microcirculation* Middle Aged Myocardial Infarction / etiology, mortality, physiopathology Myocardial Ischemia / complications, diagnosis*, mortality, physiopathology Nitroglycerin / diagnostic use Predictive Value of Tests Prognosis Risk Assessment Risk Factors Stroke / etiology, mortality, physiopathology United States Vasodilator Agents / adverse effects, diagnostic use* |
| Grant Support | |
ID/Acronym/Agency:
|
1R03AG032631/AG/NIA NIH HHS; MO1-RR00425/RR/NCRR NIH HHS; N01-HV-68161/HV/NHLBI NIH HHS; N01-HV-68162/HV/NHLBI NIH HHS; N01-HV-68163/HV/NHLBI NIH HHS; N01-HV-68164/HV/NHLBI NIH HHS; R01 HL090957/HL/NHLBI NIH HHS; T32HL69751/HL/NHLBI NIH HHS; U01 HL649141/HL/NHLBI NIH HHS; U01 HL649241/HL/NHLBI NIH HHS; U0164829//PHS HHS; UL1 TR000064/TR/NCATS NIH HHS; UL1 TR000124/TR/NCATS NIH HHS |
| Chemical | |
Reg. No./Substance:
|
0/Vasodilator Agents; 51-84-3/Acetylcholine; 55-63-0/Nitroglycerin; 58-61-7/Adenosine |
| Comments/Corrections | |
Comment In:
|
JACC Cardiovasc Interv. 2012 Jun;5(6):654-5
[PMID:
22721661
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Computed tomographic angiography-verified plaque characteristics and slow-flow phenomenon during per...
Next Document: Vascular Response of the Segments Adjacent to the Proximal and Distal Edges of the ABSORB Everolimus...