title: The impact of high sensitivity C-reactive protein level on coronary artery spasm as assessed by intracoronary acetylcholine provocation test.
abstract: OBJECTIVE
  High sensitive C-reactive protein (hs CRP) is well known as a strong risk factor of cardiovascular disease (CVD). The aim of this study is to evaluate the impact of elevated hs CRP on coronary artery spasm (CAS) as assessed by intracoronary acetylcholine (ACh) provocation test.
  
  
  METHODS
  A total of 1729 consecutive patients without significant CVD who underwent coronary angiography and intracoronary ACh test between November 2004 and August 2010 were analyzed. The patients were divided into five groups according to quintiles of hs CRP levels.
  
  
  RESULTS
  At baseline, the prevalence of elderly, hypertension, diabetes mellitus, current smoking, and lipid levels were higher in patients with higher hs CRP. During ACh test, the incidences of significant CAS, ischemic electrocardiography (EKG) change, multivessel, and diffuse CAS were higher in patients with higher hs CRP. Multivariate analysis showed that the old age (OR=1.01, CI; 1.0-1.02, p=0.0226), myocardial bridge (OR=3.34, CI; 2.16-5.17, p<0.001), and highest quintile hs CRP (OR=1.54, CI; 1.12-2.18, p=0.008) were independent predictors of ACh induced CAS. However, there was no difference in clinical outcomes up to 12 months.
  
  
  CONCLUSIONS
  In conclusion, higher hs CRP was associated with higher incidence of CAS, worse angiographic characteristics and ischemic EKG change, but was not associated with clinical outcomes.
authors.affiliation: Cardiovascular Center, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 152-703, Korea. swrha617@yahoo.co.kr.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Park
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Yong-Jian
authors.initials: YJ
authors.lastname: Li
authors.forename: Kang-Yin
authors.initials: KY
authors.lastname: Chen
authors.forename: Byoung Geol
authors.initials: BG
authors.lastname: Choi
authors.forename: Se Yeon
authors.initials: SY
authors.lastname: Choi
authors.forename: Sung Kee
authors.initials: SK
authors.lastname: Ryu
authors.forename: Jae Woong
authors.initials: JW
authors.lastname: Choi
authors.forename: Tae Kyun
authors.initials: TK
authors.lastname: Kim
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Kim
authors.forename: Yoon Suk
authors.initials: YS
authors.lastname: Bak
authors.forename: Jae Hoon
authors.initials: JH
authors.lastname: Lee
authors.forename: Sung Il
authors.initials: SI
authors.lastname: Im
authors.forename: Sun Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Jin Oh
authors.initials: JO
authors.lastname: Na
authors.forename: Cheol Ung
authors.initials: CU
authors.lastname: Choi
authors.forename: Hong Euy
authors.initials: HE
authors.lastname: Lim
authors.forename: Jin Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Eung Ju
authors.initials: EJ
authors.lastname: Kim
authors.forename: Chang Gyu
authors.initials: CG
authors.lastname: Park
authors.forename: Hong Seog
authors.initials: HS
authors.lastname: Seo
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Oh
mesh_terms: D000109:Acetylcholine / Q000378:metabolism*; D000328:Adult; D002097:C-Reactive Protein / Q000378:metabolism*; D003329:Coronary Vasospasm / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000378:metabolism; D005260:Female; D006801:Humans; D006973:Hypertension / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D002097:C-Reactive Protein; D000109:Acetylcholine
keywords: C-reactive protein; acetylcholine; coronary artery spasm