| アブストラクト | BACKGROUND: Previous studies on complications with coronary spasm provocation tests were based on small sample sizes or were limited to high-volume centers. The risk of provocation tests using acetylcholine (ACH) or ergonovine (ER) remains to be fully examined by a large-scale multicenter study. HYPOTHESIS: ACH provocation tests are associated with a higher rate of serious cardiac complications than ER tests. METHODS: Using the Diagnosis Procedure Combination database in Japan, we identified patients aged >/=20 years who underwent a pharmacological provocation test during coronary angiography. We assessed the composite outcome of cardiac complications requiring urgent procedures (defibrillation, chest compression, intra-aortic balloon pumping, or extracorporeal membrane oxygenation) or death on the day of the provocation test, and compared the outcome between ACH and ER tests. RESULTS: Of 21 512 eligible patients in 602 hospitals, 10 628 (49.4%) underwent an ACH test and 10 884 (50.6%) underwent an ER test. The composite outcome occurred in 141 (0.7%) patients. The ACH group was significantly more likely to have the composite outcome than the ER group (0.9% vs 0.4%, P < 0.001). The propensity-score analyses showed consistent results (propensity score-matched, 0.9% vs 0.4%, P = 0.003; inverse probability-weighted, 0.8% vs 0.4%, P < 0.001). In a multivariable logistic regression analysis, ACH tests were significantly associated with a higher rate of the composite outcome than ER tests (odds ratio: 1.75, 95% confidence interval: 1.13-2.69, P = 0.011). CONCLUSIONS: This retrospective cohort study suggested that ACH tests were associated with a higher rate of cardiac complications than ER tests. |
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| ジャーナル名 | Clinical cardiology |
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| 投稿日 | 2015/2/20 |
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| 投稿者 | Isogai, Toshiaki; Yasunaga, Hideo; Matsui, Hiroki; Tanaka, Hiroyuki; Ueda, Tetsuro; Horiguchi, Hiromasa; Fushimi, Kiyohide |
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| 組織名 | Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan; Department of Cardiology, Tokyo;Metropolitan Tama Medical Center, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/25693967/ |
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