Observational studyJournal of the American Heart Association2013
Coronary vasomotor response to intracoronary acetylcholine injection, clinical features, and long-term prognosis in 873 consecutive patients with coronary spasm: analysis of a single-center study over 20 years.
Observational study in Journal of the American Heart Association, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02666235 (A Randomised Controlled Trial of the Effect of Remote Ischaemic Conditioning on Coronary Endothelial Function in Patients With Angina.), which is not on this map. Cited by 81 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomised Controlled Trial of the Effect of Remote Ischaemic Conditioning on Coronary Endothelial Function in Patients With Angina.
Who cites it
81 citing papers in PubMed, 158 citations in OpenAlex.
- Acetylcholine Provocation Testing for Coronary Vasomotor Disorders.Reviews in cardiovascular medicine · 2026Review
- Coronary Artery Spasm in Patients with Type 2 Diabetes Mellitus.Life (Basel, Switzerland) · 2026Review
- Current Practice and Safety of Invasive Coronary Function Testing: A Nationwide Multicenter Survey in Japan.JACC. Advances · 2026Article
- Epicardial vasospasm and concomitant ventricular tachycardia treated with Beta-1-specific Beta-blockade: a case series in support of nebivolol.European heart journal. Case reports · 2026Article
- Vasospastic angina: Pathophysiology, diagnosis, and emerging therapeutic approaches.World journal of cardiology · 2025Review
- Prognostic significance of individual COVADIS criteria in patients undergoing acetylcholine provocation testing.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Article
- Cardiac Repair and Regeneration via Advanced Technology: Narrative Literature Review.JMIR biomedical engineering · 2025Review
- Paroxysmal Atrial Fibrillation during Spasm Provocation Test with Acetylcholine: Clinical Characteristics of Patients and Effect on Coronary Microvascular Function Measurements.Reviews in cardiovascular medicine · 2025Article
- Clinical Limitations of Vasoreactivity Testing as a Diagnostic Tool in Patients with Vasospastic Angina.Internal medicine (Tokyo, Japan) · 2025Review
- Let us pay more attention to performing coronary function assessment for multivessels!Cardiovascular diagnosis and therapy · 2024Article
- Lack of Class I Vasoreactivity Testing for Diagnosing Patients With Coronary Artery Spasm.Clinical cardiology · 2024Review
- Factors Contributing to Coronary Microvascular Dysfunction in Patients with Angina and Non-Obstructive Coronary Artery Disease.Journal of cardiovascular development and disease · 2024Article
- Recurrent syncope due to ischemia with non-obstructive coronary artery disease: a case report.Journal of medical case reports · 2024Article
- Coronary Spasm Testing with Acetylcholine: A Powerful Tool for a Personalized Therapy of Coronary Vasomotor Disorders.Life (Basel, Switzerland) · 2024Review
- Muscarinic control of cardiovascular function in humans: a review of current clinical evidence.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2024Review
- A Personalized Approach for Patients with Myocardial Infarction with Non-Obstructive Coronary Arteries.Reviews in cardiovascular medicine · 2024Review
- Do changes in intracoronary pressure aid coronary spasm diagnosis using the spasm provocation test?World journal of cardiology · 2024Article
- Clinical Characteristics and Major Adverse Cardiovascular Events in Diabetic and Non-Diabetic Patients with Vasospastic Angina.Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Article
- Clinical Characteristics and Major Adverse Cardiovascular Events in Diabetic and Non-Diabetic Patients with Vasospastic Angina [Response to Letter].Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Article
- Clinical Characteristics and Major Adverse Cardiovascular Events in Diabetic and Non-Diabetic Patients with Vasospastic Angina [Letter].Diabetes, metabolic syndrome and obesity : targets and therapy · 2024Article
21 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
15 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of this study was to elucidate the correlation between angiographic coronary vasomotor responses to intracoronary acetylcholine (ACh) injection, clinical features, and long-term prognosis in patients with vasospastic angina (VSA). METHODS AND
resultsThis is a retrospective, observational, single-center study of 1877 consecutive patients who underwent ACh-provocation test between January 1991 and December 2010. ACh-provoked coronary spasm was observed in 873 of 1637 patients included in the present analysis. ACh-positive patients were more likely to be older male smokers with dyslipidemia, to have a family history of ischemic heart disease, and to have a comorbidity of coronary epicardial stenosis than were ACh-negative patients. ACh-positive patients were divided into 2 groups: those with focal (total or subtotal obstruction, n=511) and those with diffuse (severe diffuse vasoconstriction, n=362) spasm patterns. Multivariable logistic regression analysis identified female sex and low comorbidity of coronary epicardial stenosis to correlate with the ACh-provoked diffuse spasm pattern in patients with VSA. Kaplan-Meier survival curve indicated better 5-year survival rates free from major adverse cardiovascular events in patients with diffuse spasm pattern compared with those with focal spasm pattern (P=0.019). Multivariable Cox hazard regression analysis identified diffuse spasm pattern as a negative predictor of major adverse cardiovascular events in patients with VSA.
conclusionsACh-induced diffuse coronary spasm was frequently observed in female VSA patients free of severe coronary epicardial stenosis and was associated with better prognosis than focal spasm. These results suggest the need to identify the ACh-provoked coronary spasm subtypes in patients with VSA.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.