ArticleEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2022
Safety and prognostic relevance of acetylcholine testing in patients with stable myocardial ischaemia or myocardial infarction and non-obstructive coronary arteries.
Article in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05714319 (Intracoronary Provocative Test With Acetylcholine in Patients With Stable Myocardial Ischemia or Myocardial Infarction and Non-Obstructive Coronary Arteries), which is not on this map. Cited by 47 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.
Intracoronary Provocative Test With Acetylcholine in Patients With Stable Myocardial Ischemia or Myocardial Infarction and Non-Obstructive Coronary Arteries: the "Provoke" Study
Who cites it
47 citing papers in PubMed, 69 citations in OpenAlex.
- Intravascular imaging in myocardial infarction and ischemia with nonobstructive coronary arteries.Cardiovascular intervention and therapeutics · 2026Review
- A proposal of an echocardiography-based pathway for the diagnosis and management of angina with no obstructive coronary arteries: a state-of-the-art review: Advancing Targeted Therapy and Prognosis Through Endotype Identification.European heart journal. Imaging methods and practice · 2026Review
- Clinical and Physiological Predictors of Acetylcholine-Induced Coronary Spasm in ANOCA/INOCA Patients: A Retrospective Cohort Study.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
- Diagnostic Advancements in MINOCA: Do They Translate to a Better Clinical Outcome? A Review of the Literature.Medicina (Kaunas, Lithuania) · 2026Review
- Multimodality Imaging to Determine Underlying Causes of Myocardial Infarction With Nonobstructive Coronary Arteries in Women and Men.Circulation · 2026Article
- Beyond Stenosis: Mechanism-Based Multimodality Imaging and Invasive Coronary Function Testing for Endotype Definition in ANOCA/INOCA.Medicina (Kaunas, Lithuania) · 2026Review
- Chronic ischemic heart disease: A nonuniform syndrome.American heart journal plus : cardiology research and practice · 2026Review
- Coronary Physiology Across the Whole Spectrum of Ischemic Heart Disease.Journal of clinical medicine · 2026Review
- Coronary artery spasm: mechanisms, risk factors, and translational strategies for precision management.Frontiers in cardiovascular medicine · 2026Review
- Controlled hyperventilation using a new ventilation navigator software: a feasibility study to provoke hypocapnia and respiratory alkalosis: A proposal for coronary artery vasoreactivity assessment.European heart journal. Imaging methods and practice · 2026Article
- Article
- Ischemia with Non-Obstructive Coronary Artery Disease: Sex-Based Differences in Pathophysiology, Clinical Presentation, and Prognosis.Journal of clinical medicine · 2025Review
- The PROMISE of Precision Medicine in Myocardial Infarction with Non-Obstructive Coronary Arteries.Methods and protocols · 2025Review
- Endothelial Cell-Derived Extracellular Vesicles Allow to Differentiate Between Various Endotypes of INOCA: A Multicentre, Prospective, Cohort Study.Journal of cardiovascular translational research · 2025Article
- Unveiling the coronary acetylcholine test: can it help us predict future cardiovascular events?EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Article
- 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
- Routine diagnosis of ANOCA/INOCA: pros and cons.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Article
- Sex-Related Differences in the Prognostic Role of Acetylcholine Provocation Testing.Journal of the American Heart Association · 2025Article
- Angina Severity and Symptom Improvement Are Associated With Diagnostic Acetylcholine Provocation Dose in Vasospastic Angina.Journal of the American Heart Association · 2025Observational
- Coronary microvascular dysfunction: pathophysiology, diagnosis, and therapeutic strategies across cardiovascular diseases.EXCLI journal · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIntracoronary provocation testing with acetylcholine (ACh) is crucial for the diagnosis of functional coronary alterations in patients with suspected myocardial ischaemia and non-obstructive coronary arteries.
aimsOur intention was to assess the safety and predictive value for major adverse cardiovascular and cerebrovascular events (MACCE) in patients presenting with ischaemia with non-obstructive coronary arteries (INOCA) or with myocardial infarction with non-obstructive coronary arteries (MINOCA).
methodsWe prospectively enrolled consecutive INOCA or MINOCA patients undergoing intracoronary ACh provocation testing.
resultsA total of 317 patients were enrolled: 174 (54.9%) with INOCA and 143 (45.1%) with MINOCA. Of these, 185 patients (58.4%) had a positive response to the ACh test. Complications during ACh provocative testing were all mild and transient and occurred in 29 (9.1%) patients, with no difference between patients with positive or negative responses to ACh testing, nor between INOCA and MINOCA patients. A history of paroxysmal atrial fibrillation, moderate/severe diastolic dysfunction and a higher QT dispersion at baseline electrocardiogram were independent predictors of complications. MACCE occurred in 30 patients (9.5%) during a median follow-up of 22 months. The incidence of MACCE was higher among patients with a positive ACh test (24 [13.0%] vs 6 [4.5%], p=0.017), and a positive ACh test was an independent predictor of MACCE.
conclusionsACh provocation testing is associated with a low risk of mild and transient complications, with a similar prevalence in both INOCA and MINOCA patients. Importantly, ACh provocation testing can help to identify patients at higher risk of future clinical events, suggesting a net clinical benefit derived from its use in this clinical setting.
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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.