Diagnosis of coronary artery spasm by ergonovine provocation test of radial artery

Abstract

We investigated the sensitivity, specificity and safety of ergonovine provocation test of radial artery in the diagnosis of coronary artery spasm (CAS). The patients who came to our hospital for chest pain from January to June 2020 as well as had coronary stenosis < 50% and no radial artery stenosis, were enrolled in this study. These patients were divided into CAS group and control group after intracoronary ergonovine provocation test. All patients underwent ergonovine provocation test of radial artery, the inner diameter (D0 and D1) and the peak systolic velocities (PSV0 and PSV1) of the radial artery were measured by ultrasound before and after ergonovine provocation. The predictive value of ergonovine provocation test of radial artery for the diagnosis of CAS was analyzed using receiver operator characteristic (ROC) curve. There were 19 patients in the CAS group and 28 patients in the control group. Low density lipoprotein cholesterol and smoking rate were significantly higher in the CAS group than in the control group (all P < 0.05), but there were no significant differences in other items (P > 0.05) between the two groups. In the ergonovine provocation test of radial artery, degree of radial artery stenosis was significantly higher in the CAS group [41.50% (35.60%, 50.00%)] than in the control group [11.25% (5.15%, 23.00%)] (P = 0.000), but there were no siginificant differences in D0, PSV0 and PSV1 between the two groups (P > 0.05). The area under ROC curve of ergonovine (120 µg) provocation test of radial artery for the diagnosis of CAS was 0.912 with 95%CI: 0.792–0.975, P = 0.001, cut-off of 31%, specificity of 92.86% and sensitivity of 84.21%. The ergonovine (120 µg) provocation test of radial artery did not cause any adverse reactions. We concluded that the ergonovine provocation test of radial artery has high sensitivity, specificity and safety in the diagnosis of CAS.

Dysregulation Serum miR-19a-3p is a Diagnostic Biomarker for Asymptomatic Carotid Artery Stenosis and a Promising Predictor of Cerebral Ischemia Events

“…At present, the preferred non-invasive diagnosis method of CAS in clinical practice is duplex ultrasound imaging, which is simple and safe, but it is easily affected by the level of operators, and it is expensive and not suitable for large-scale screening of the population. 5 The search for new, noninvasive, and less costly methods for the screening diagnosis of asymptomatic CAS is still expected to be developed.…”

“…4 However, current imaging has different deficiencies in the diagnosis of moderate stenosis (>50%) or severe stenosis (>70%) in asymptomatic CAS patients. For example, the preferred noninvasive diagnosis method of CAS in clinical practice is duplex ultrasound imaging, which is simple and safe, but it is easily affected by the level of operators, and it is expensive and not suitable for large-scale screening of the population [5][6][7] Therefore, the current priority is to identify and treat asymptomatic CAS patients as early as possible through noninvasive and low-cost methods to reduce the risk of stroke.…”

Vasospastic Angina in a Young Woman: A Case Report

“…Sueda et al reported no RAS during the SPT performed by radial artery puncture [ 18 ]. However, studies reported that RAS is more likely to occur when NTG administration cannot be used immediately after radial artery puncture [ 19 ], and other studies reported an association between RAS and coronary spasm [ 20 ]. The possibility of RAS should be considered when conducting an SPT via radial artery puncture, as in this case.…”