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The following is a summary of “Effects of radial artery spasm prophylaxis on intracoronary vasomotor responses during acetylcholine spasm provocation testing,” published in the January 2025 issue of Cardiology by Schäufele et al. 

The impact of radial artery spasm prophylaxis (RASP) on coronary spasm provocation testing results after diagnostic angiography had not been previously established.  

Researchers conducted a retrospective study to examine the effects of RASP on vasomotor responses during intracoronary acetylcholine (ACh) testing.  

They assessed 372 patients (51% female, mean age 61 ± 11 years) with angina and non-obstructive coronary arteries who underwent intracoronary provocation with ACh following a standardized protocol. Clinical discomfort, ischemic electrocardiographic changes, and epicardial lumen reductions were recorded, of the patients, 156 (42%) received RASP with 200 μg nitroglycerin and 2.5 mg verapamil, while 216 (58%) did not. The 2 groups were compared based on age, sex, cardiovascular risk factors, and ACh-test results.  

The results showed no significant difference in pathological ACh test results between the RASP group (71 patients, 46%) and the non-RASP group (103 patients, 48%) (P = 0.752). Epicardial spasm occurred in 20 patients (28%) with RASP and 42 patients (41%) without RASP (P = 0.120), while microvascular spasm occurred in 51 patients (72%) with RASP and 61 patients (59%) without RASP (P = 0.362) while, RASP did not significantly affect coronary vasomotor responses, including frequency (P = 0.752), type of spasm (P = 0.108), or the ACh dose leading to spasm (P = 0.151).  

Investigators concluded that RASP did not significantly influence coronary vasomotor responses to ACh, suggesting that its routine administration can be safely implemented even in patients undergoing intracoronary spasm testing. 

Source: sciencedirect.com/science/article/abs/pii/S0167527324013251