E0104 Matched case-control study on mechanism of radial artery spasm. (17th November 2010)

• Record Type: Journal Article
• Authors: Dean, Jia; Yujie, Zhou; Dongmei, Shi; Zhijian, Wang; Shiwei, Yang; Xiaoli, Liu
• Is Part Of: Heart. Volume 96(2010)Supplement 3
• Page Start: A34
• Page End: A34
• Publication Date: 2010-11-17
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2010.208967.104
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objects: Radial artery (RAS) spasm is the most common complication in transradial coronary angiography and intervention. The aim of this study is to preliminary discuss the relationship between vaso-active substances and RAS, find out the mechanism of RAS, and provide theoretic evidence for the solution of RAS prevention. Methods: This is a prospective, matched case-control study. The patients who received transradial coronary angiography were enrolled. The patients who suffered from RAS during the procedure were enrolled, and the patients without RAS were matched 1:2 according to same gender, similar age within 2 years. The diagnostic criteria are clinical definition of RAS based on a questionnaire which was documented by angiography. Blood samples were obtained before the procedure, and were tested for nitric oxide, endothelin-1, prostacyclin, thromboxane A2 and norepinephrine using enzyme-linked-immunosorbent assay. The concentration of each vaso-active substance was compared and multi logistic regression was made to find out the risk factors of RAS. Results: 30 patients suffered form RAS and 60 patients without RAS were enrolled. of all the clinical and procedural characteristics, successful access at first attempt (46.7% vs 75.0%, p=0.010) and ratio of severe pain at cannulation (13.3% vs 1.7%, p=0.041) were different between the RAS group and the control group, the others were of no difference. The concentration of nitric oxide (64.5512±24.2963 vs 57.6385±20.1472, p=0.426) and thromboxane A2 (0.9040±0.2158 vs 0.7364±0.2256, p=0.372) was of no difference between the RAS group and the control group. The concentration of endothelin-1 (276.3739±85.1481 vs 78.5275±23.6323, p<0.001) and norepinephrine (193.7551±41.8509 vs 54.4108±17.8031, p=0.006) was higher, prostacyclin (8.1947±3.2692 vs 14.5436±5.5867, p=0.041) was lower in RAS group. Multiple regression showed that endothelin-1 (OR 2.714, 95% CI 1.329 to 4.984, p=0.005) and norepinephrine (OR 4.285, 95% CI 2.219 to 10.372, p=0.014) were the risk factors of RAS during the procedure. Conclusions: Among the vaso-active substances, the concentration of nitric oxide and thromboxane A2 was of no difference, prostacyclin was lower and endothelin-1, norepinephrine was higher in RAS patients than in patients without RAS. Multiple regression showed that endothelin-1 and norepinephrine were the risk factors of RAS during the procedure.