Author + information
- S1936879815020579-a40d7c8627938661b77870d969786af2Hu Li,
- S1936879815020579-83e45353357d710a9dde9c5071cfa225Seung-Woon Rha,
- S1936879815020579-5ad2c1999ed23ad295759ce26e3acbe8Se Yeon Choi,
- S1936879815020579-80e1093da6436e5842089aa7e6953d95Jae Kyeong Byun,
- S1936879815020579-38f9379288aee4a50a9131fa84c4a249Byoung Geol Choi,
- S1936879815020579-ba557881026de47c124e10c217357ba7Jin Oh Na,
- S1936879815020579-75651d7c97f1b405cb9898f53b81332dCheol Ung Choi,
- S1936879815020579-8f4a68dbf9c168e3c5b8e0921fc1fdc5Hong Euy Lim,
- S1936879815020579-0917d647c4dd4abf30331a6392c2e02eJin Won Kim,
- S1936879815020579-b218fd237ec3d894d36671745a53ded2Eung Ju Kim,
- S1936879815020579-296ff6d9f84d6c895803c2c14e42681cChang Gyu Park,
- S1936879815020579-ccbdaa58f4378c09033eae0241b12ba5Hong Seog Seo and
- S1936879815020579-2c7637807d41347deaf1951130df7e8bDong Joo Oh
Diabetes mellitus (DM) is known to be a risk factor of significant coronary artery disease (CAD) and endothelial dysfunction. However, currently there is limited data regarding the impact of insulin treatment on significant coronary artery spasm (CAS) in real world clinical practice particularly in Asian population.
A total 703 consecutive patients (pts) underwent intracoronary acetylcholine (Ach) provocation test were enrolled. Provocation test was performed by incremental dosages (20, 50, 100ug) of Ach until get significant response (>70% narrowing). The study population were divided into insulin treatment group [Insulin group; n=72, CAS (+) n=44] and oral hypoglycemic agents [OHA group, n=631, CAS (+) n=382). Angiographic and clinical parameters during Ach provocation test were compared between the two groups. We investigated the clinical outcomes of significant CAS pts in both groups throughout 5 years.
Baseline characteristics were similar between the two groups. During Ach provocation test, angiographic parameters and clinical parameters are not different between the two groups. Among the (+) CAS pts, 5 years individual and composite clinical outcomes were not different between the two group except that insulin treatment group showed higher incidence of repeat follow up coronary angiography (CAG) due to recurrent angina (Table).
According to current study, insulin treatment was not associated with significant CAS but significant CAS pts with insulin treatment were associated with higher incidence of adverse outcomes. Special care should be exercised for CAS pts with insulin treatment.