Coronary Artery Disease, Coronary Vasospasm, Microvascular Angina
Conditions
Keywords
Acetylcholine
Brief summary
In patients with chest pain and/or shortness of breath coronary artery disease (CAD) is suspected depending on the pattern of symptoms and the electrocardiogram (ECG). Coronary angiography is the method of choice to verify this suspicion. If the patient coronary arteries on coronary angiography are totally normal or unobstructed, one can only speculate if the patients' discomfort is from the heart or not. A possibility to get further information about the healthiness of the coronary arteries is the acetylcholine test (ACH-test). When injecting this natural, body produced-substance into the coronary arteries one can test if the vessels develop coronary spasm which can be the reason for the patient's symptoms. The investigators therefore use this test in this study to look for coronary spasm in patients with suspected CAD but normal/unobstructed coronary arteries. In case of a positive test, the patient profits from having found a cause for his/her symptoms making treatment with special tablets possible. Furthermore, the investigators want to analyze blood samples of every patient to look for signs of inflammation, vasoconstriction and genetic variants that seem to be linked with coronary spasms. On the basis of these results the ACH-test could probably be avoided in the future.
Interventions
OTHERIntracoronary acetylcholine provocation test
Intracoronary provocation of coronary spasm with acetylcholine in augmented dosages of 2 µg, 20 µg, 100 µg and 200 µg non-selectively in the LCA as well as 80 µg in the RCA. During the procedure, a 12 channel ECG will be recorded.
Sponsors
Deutsche Stiftung für Herzforschung
Peter Ong, MD
Study design
Allocation
NON_RANDOMIZED
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
35 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults between 35 and 95 years old with angina pectoris and/or dyspnea suggestive of coronary artery disease with non-invasive proof of coronary ischemia or high pre-test probability for CAD who will be referred for coronary angiography * Serum creatinine \< 1,4 md/dl * Left ventricular ejection fraction \> 50%
Exclusion criteria
* Patients under 35 years and above 95 years of age * Severe chronic obstructive pulmonary disease (contraindication for acetylcholine-testing)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| all cause mortality (cardiac vs. non-cardiac) | 12-120 months |
Secondary
| Measure | Time frame |
|---|---|
| Angina pectoris, repeated angiography, re-admissions for angina pectoris | 12-120 months |
Countries
Germany
Contacts
Primary ContactPeter Ong, MD
Backup ContactAndreas Seitz, MD
Outcome results
None listed