title: The 24-Month Prognosis of Patients With Positive or Intermediate Results in the Intracoronary Ergonovine Provocation Test.
abstract: OBJECTIVE
  This study was an observational, multicenter registry to determine clinical characteristics and 24-month prognosis of patients who underwent intracoronary ergonovine provocation tests.
  
  
  BACKGROUND
  The clinical characteristics and prognosis of patients who underwent the ergonovine provocation for vasospastic angina were not fully elucidated.
  
  
  METHODS
  A total of 2,129 patients in the VA-KOREA (Vasospastic Angina in Korea) registry were classified into positive (n = 454), intermediate (n = 982), and negative (n = 693) groups by intracoronary ergonovine provocation tests. The 24-month incidences of cardiac death, new-onset arrhythmia, and acute coronary syndrome were determined (mean 26.7 ± 8.8 months).
  
  
  RESULTS
  The number of smokers, frequency of angina before angiography, high-sensitivity C-reactive protein, and triglyceride were higher in the positive group than in other groups. The clinical characteristics of the intermediate and the negative groups were very similar. In the positive group, the incidences of diffuse, focal, and mixed spasm were 65.9%, 23.6%, and 10.6%. Coronary spasm was more frequently provoked on atherosclerotic segments. The 24-month incidences of cardiac death, arrhythmia, and acute coronary syndrome were low (0.9%, 1.6%, and 1.9%, respectively) in the positive group, and there was no cardiac death in the intermediate group (p = 0.02). In the positive group, frequent angina, current smoking, and multivessel spasm were independent predictors for adverse events.
  
  
  CONCLUSIONS
  The 24-month prognosis of the positive group in the intracoronary ergonovine provocation test was relatively worse than that of the intermediate group. More intensive clinical attention should be paid to vasospastic angina patients with high-risk factors including frequent angina before angiography, current smoking, and multivessel spasm.
authors.affiliation: Department of Cardiovascular Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, South Korea.
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Shin
authors.affiliation: Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea. Electronic address: whitesh@catholic.ac.kr.
authors.forename: Sang Hong
authors.initials: SH
authors.lastname: Baek
authors.affiliation: Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, South Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Her
authors.affiliation: Gil Medical Center, Gachon University, Incheon, South Korea.
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Han
authors.affiliation: Chonnam National University Hospital, Chonnam National University, Gwangju, South Korea.
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.affiliation: Chonnam National University Hospital, Chonnam National University, Gwangju, South Korea.
authors.forename: Keun-Ho
authors.initials: KH
authors.lastname: Park
authors.affiliation: Busan Paik Hospital, Inje University, Busan, South Korea.
authors.forename: Dong-Soo
authors.initials: DS
authors.lastname: Kim
authors.affiliation: Busan Paik Hospital, Inje University, Busan, South Korea.
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Yang
authors.affiliation: Bundang Hospital, Seoul National University, Seongnam, South Korea.
authors.forename: Dong-Ju
authors.initials: DJ
authors.lastname: Choi
authors.affiliation: Bundang Hospital, Seoul National University, Seongnam, South Korea.
authors.forename: Jung-Won
authors.initials: JW
authors.lastname: Suh
authors.affiliation: Gangnam Severance Hospital, Yonsei University, Seoul, South Korea.
authors.forename: Hyuck Moon
authors.initials: HM
authors.lastname: Kwon
authors.affiliation: Gangnam Severance Hospital, Yonsei University, Seoul, South Korea.
authors.forename: Byoung Kwon
authors.initials: BK
authors.lastname: Lee
authors.affiliation: Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea.
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
authors.affiliation: Guro Hospital, Korea University, Seoul, South Korea.
authors.forename: Seung-Woon
authors.initials: SW
authors.lastname: Rha
authors.affiliation: Pyeongchon Sacred Heart Hospital, Hallym University, Anyang, South Korea.
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Jo
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D003329:Coronary Vasospasm / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D003331:Coronary Vessels / Q000187:drug effects* / Q000503:physiopathology; D018450:Disease Progression; D018572:Disease-Free Survival; D004874:Ergonovine / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000401:mortality; D013997:Time Factors; D014661:Vasoconstriction / Q000187:drug effects*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
chemical_list: D014662:Vasoconstrictor Agents; D004874:Ergonovine
keywords: ergonovine; prognosis; vasospastic angina