Yonsei Med J.  2013 Nov;54(6):1299-1304. 10.3349/ymj.2013.54.6.1299.

The Impact of High Sensitivity C-Reactive Protein Level on Coronary Artery Spasm as Assessed by Intracoronary Acetylcholine Provocation Test

• Park JY
• Rha SW
• Li YJ
• Chen KY
• Choi BG
• Choi SY
• Ryu SK
• Choi JW
• Kim TK
• Kim JM
• Bak YS
• Lee JH
• Im SI
• Kim SW
• Na JO
• Choi CU
• Lim HE
• Kim JW
• Kim EJ
• Park CG
• Seo HS
• Oh DJ

• KMID: 1798123
• DOI: http://doi.org/10.3349/ymj.2013.54.6.1299

Abstract

PURPOSE
High sensitive C-reactive protein (hs CRP) is well known as a strong risk factor of cardiovascular disease (CVD). The aim of this study is to evaluate the impact of elevated hs CRP on coronary artery spasm (CAS) as assessed by intracoronary acetylcholine (ACh) provocation test.
MATERIALS AND METHODS
A total of 1729 consecutive patients without significant CVD who underwent coronary angiography and intracoronary ACh test between November 2004 and August 2010 were analyzed. The patients were divided into five groups according to quintiles of hs CRP levels.
RESULTS
At baseline, the prevalence of elderly, hypertension, diabetes mellitus, current smoking, and lipid levels were higher in patients with higher hs CRP. During ACh test, the incidences of significant CAS, ischemic electrocardiography (EKG) change, multivessel, and diffuse CAS were higher in patients with higher hs CRP. Multivariate analysis showed that the old age (OR=1.01, CI; 1.0-1.02, p=0.0226), myocardial bridge (OR=3.34, CI; 2.16-5.17, p<0.001), and highest quintile hs CRP (OR=1.54, CI; 1.12-2.18, p=0.008) were independent predictors of ACh induced CAS. However, there was no difference in clinical outcomes up to 12 months.
CONCLUSION
In conclusion, higher hs CRP was associated with higher incidence of CAS, worse angiographic characteristics and ischemic EKG change, but was not associated with clinical outcomes.

Keyword

C-reactive protein; acetylcholine; coronary artery spasm

MeSH Terms

Acetylcholine/*metabolism
Adult
C-Reactive Protein/*metabolism
Coronary Vasospasm/*metabolism
Diabetes Mellitus/metabolism
Female
Humans
Hypertension/metabolism
Male
Middle Aged
Retrospective Studies
Acetylcholine
C-Reactive Protein

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