title: Endothelial dysfunction and the occurrence of radial artery spasm during transradial coronary procedures: the ACRA-Spasm study.
abstract: OBJECTIVE
  The aim of this study was to analyse the relation between endothelial dysfunction (ED) and the occurrence of radial artery spasm (RAS) during transradial coronary procedures.
  
  
  RESULTS
  From May 2014 to June 2015, endothelial function was assessed by EndoPAT and FMD before the procedure in 165 patients referred for coronary angiography or intervention. The primary endpoint was RAS, defined by patient's symptoms and procedural characteristics. The mean age of the study population was 63 years and 71% were male. In total 16% of the patients experienced RAS. The incidence of RAS did not differ between patients with and without ED (13.8% vs. 20.2%, OR 0.63, 95% CI: 0.25-1.58, p=0.32). The strongest predictors of RAS were a ratio of radial artery inner diameter and sheath outer diameter smaller than 1 (OR 4.7, 95% CI: 1.35-16.5, p=0.009) and a combination of clinical characteristics presented as an RAS risk score of at least 4 (p=0.007, OR 3.7, 95% CI: 1.37-9.89).
  
  
  CONCLUSIONS
  Endothelial dysfunction was not found to be a predictor of the occurrence of radial artery spasm in a cohort of patients undergoing elective heart catheterisation. Radial artery-sheath mismatch is the strongest pre-procedural predictor of RAS.
authors.affiliation: Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Dirk
authors.initials: D
authors.lastname: van der Heijden
authors.forename: Maarten A H
authors.initials: MA
authors.lastname: van Leeuwen
authors.forename: Gladys N
authors.initials: GN
authors.lastname: Janssens
authors.forename: Jailen
authors.initials: J
authors.lastname: Hermie
authors.forename: Mattie J
authors.initials: MJ
authors.lastname: Lenzen
authors.forename: Marco J P F
authors.initials: MJ
authors.lastname: Ritt
authors.forename: Peter M
authors.initials: PM
authors.lastname: van de Ven
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Kiemeneij
authors.forename: Niels
authors.initials: N
authors.lastname: van Royen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D042783:Endothelial Cells; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D017534:Radial Artery / Q000503:physiopathology / Q000601:surgery*; D018570:Risk Assessment; D013035:Spasm / Q000453:epidemiology* / Q000601:surgery*; D014652:Vascular Diseases / Q000601:surgery*