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Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
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Published on: August 18, 2016

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Features of atherosclerosis in patients with angina and no obstructive coronary artery disease

Dario Pellegrini1,2, Regina Konst1, Stijn van den Oord1

  • 1Radboud University Medical Center, Department of Cardiology, Nijmegen, the Netherlands.

Eurointervention : Journal of Europcr in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
|January 27, 2022
PubMed

Insights

Coronary vasospasm in patients with angina and no obstructive coronary artery disease is linked to increased lipid burden and plaque vulnerability. This finding highlights specific atherosclerotic features associated with coronary vasomotor dysfunction.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Medical Imaging

Background:

  • Atherosclerosis and coronary vasospasm association suggested but not conclusively proven.
  • Limited data exists on the full spectrum of these related cardiovascular disorders.

Purpose of the Study:

  • Define specific atherosclerotic morphological features in patients with angina and no obstructive coronary artery disease (ANOCA).
  • Investigate the link between coronary vasospasm and atherosclerosis characteristics in ANOCA patients.

Main Methods:

  • Enrolled 75 ANOCA patients undergoing coronary function tests (CFT) including acetylcholine and adenosine challenges.
  • Utilized optical coherence tomography (OCT) to assess lipid index (LI) and plaque vulnerability markers.
  • Grouped patients based on acetylcholine-induced coronary vasospasm (ACH+ vs. ACH-).

Main Results:

  • ACH+ patients exhibited significantly higher lipid index (LI) and prevalence of vulnerable plaques compared to ACH- patients.
  • Neovascularization was more prevalent in ACH+ individuals (37% vs. 6%).
  • A trend towards higher prevalence of vulnerable plaque markers, including thin-cap fibroatheroma, was observed in ACH+ patients.

Conclusions:

  • Coronary vasospasm, irrespective of its pattern, correlates with increased lipid burden and plaque vulnerability.
  • Findings suggest a significant association between coronary vasospasm and specific atherosclerotic features in ANOCA.
Abstract

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