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ȣ - 490783 184 |
| Coronary Endothelial Dysfunction Does Not Always Associated with Increasing Aging |
| Cardiovascular Center, Korea University Guro Hospital¹ , Korea University Ansan Hospital² , Korea University Anam Hospital³ |
| Soon Yong Suh¹, Seung-Woon Rha¹ , Uk Yeol Chwe¹ , Jin Won Kim¹ , Jeong Cheon Ahn² , Woo Hyuk Song² , Chang Gyu Park¹ , Hong Seog Seo¹ , Dong Joo Oh¹ , Young Moo Ro³ |
Background: Previous reports suggested that coronary artery spasm is increasing with age probably due to endothelial dysfunction. We investigated whether the coronary endothelial dysfunction and related parameters induced by acetylcholine (Ach) provocation test is related to normal aging process.
Methods: A total 400 patients (pts, 214 men, mean age 56.1 ± 11.6 years, range 20-82 years) who underwent diagnostic coronary angiography with incremental acetylcholine provocation test were enrolled for the study. The incidence of (+) provocation test, spasm severity & patterns (focal or diffuse) and spasm associated clinical parameters were analyzed among every decades.
Results: Seventy two percent of enrolled pts showed positive Ach provocation test (246/400). The proportion of positive provocation, the severity (severe spasm), the pattern (focal or diffuse), typical chest pain and ST-T change during provocation test were not significantly associated with increasing age (p=NS, Table).
Conclusion: Coronary endothelial dysfunction induced by Ach provocation test does not always seem to be associated with increasing age. Adequate medical therapy should be directed to the pts with (+) provocation test regardless of pt’s age.
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Table. The spasm severity, pattern, ECG change,
chest pain according to age
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Total=400
pts |
Positive
provocation |
Spasm
severity
(severe) |
Spasm
Pattern
(diffuse) |
Typical
chest pain |
ECG
Change
(ST
change) |
|
P-value |
0.70 |
0.21 |
0.33 |
0.35 |
0.39 |
|
lower30
years(n=9) |
4(44%) |
- |
1(11.1%) |
1(11.1%) |
- |
|
31-40years
(n=25) |
14(56%) |
4(24%) |
9(36%) |
8(32.0%) |
2(8%) |
|
41-50years
(n=87) |
56(64.4%) |
21(24.1%) |
39(44.8%) |
39(44.8%) |
6(6.8%) |
|
51-60years
(n=132) |
75(56.8%) |
23(17.4%) |
61(46.2%) |
54(40.9%) |
12(9.1%) |
|
61-70years
(n=113) |
76(67.3%) |
14(12.4%) |
57(50.4%) |
43(38.1%) |
4(3.6%) |
|
Over70years
(n=34) |
21(61.8%) |
12(17.7%) |
15(44.1%) |
16(47.1%) |
3(8.8%) |
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