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Predictors of inexplicable coronary artery spasm during coronary angiography in patients with stable angina--the role of intravascular oxidative stress.

Abstract：

OBJECTIVE:This study was conducted to investigate the potential role of intravascular oxidative stress in inexplicable episodes of coronary artery spasm (CAS) during coronary angiography (CAG). DESIGN AND METHODS:Serial patients with stable angina scheduled for routine CAG were prospectively evaluated. Patients with clinical evidence of variant angina were excluded. Blood sampling was done immediately before CAG. RESULTS:Inexplicable episodes of CAS were identified during CAG in 7 patients with and 8 patients without significant coronary artery disease (CAD). Compared to those without CAS (n=220), the 15 patients with CAS had significantly increased plasma triglyceride level, white blood cell (WBC) count and superoxide production in whole blood, and reduced plasma high-density lipoprotein (HDL) level. In multivariate analysis, CAS episodes were associated with an elevated baseline WBC count (relative risk, RR, of increasing one tertile, 2.49) and peak whole blood superoxide production (RR, 2.36), and a reduced plasma HDL level (RR, 0.37). CONCLUSIONS:Both an increased WBC count and superoxide production in whole blood preceded and predicted the inexplicable development of CAS during CAG irrespective of the presence of CAD, suggesting that intravascular oxidative stress might be the major mediator. Antioxidants given before CAG may be warranted to prevent CAS episodes.

journal_name

Clin Biochem

journal_title

Clinical biochemistry

authors

Leu HB,Lin WT,Lin CP,Wu TC,Lin SJ,Chen JW

doi

10.1016/j.clinbiochem.2009.01.021

subject

Has Abstract

pub_date

2009-05-01 00:00:00

pages

570-7

issue

7-8

eissn

0009-9120

issn

1873-2933

pii

S0009-9120(09)00044-7

journal_volume

42

pub_type

杂志文章

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