PMID- 22721660
OWN - NLM
STAT- MEDLINE
DCOM- 20121029
LR  - 20240213
IS  - 1876-7605 (Electronic)
IS  - 1936-8798 (Print)
IS  - 1936-8798 (Linking)
VI  - 5
IP  - 6
DP  - 2012 Jun
TI  - Safety of coronary reactivity testing in women with no obstructive coronary 
      artery disease: results from the NHLBI-sponsored WISE (Women's Ischemia Syndrome 
      Evaluation) study.
PG  - 646-53
LID - 10.1016/j.jcin.2012.01.023 [doi]
AB  - OBJECTIVES: This study evaluated the safety of coronary reactivity testing (CRT) 
      in symptomatic women with evidence of myocardial ischemia and no obstructive 
      coronary artery disease (CAD). BACKGROUND: Microvascular coronary dysfunction 
      (MCD) in women with no obstructive CAD portends an adverse prognosis of a 2.5% 
      annual major adverse cardiovascular event (MACE) rate. The diagnosis of MCD is 
      established by invasive CRT, yet the risk of CRT is unknown. METHODS: The authors 
      evaluated 293 symptomatic women with ischemia and no obstructive CAD, who 
      underwent CRT at 3 experienced centers. Microvascular function was assessed using 
      a Doppler wire and injections of adenosine, acetylcholine, and nitroglycerin into 
      the left coronary artery. CRT-related serious adverse events (SAEs), adverse 
      events (AEs), and follow-up MACE (death, nonfatal myocardial infarction [MI], 
      nonfatal stroke, or hospitalization for heart failure) were recorded. RESULTS: 
      CRT-SAEs occurred in 2 women (0.7%) during the procedure: 1 had coronary artery 
      dissection, and 1 developed MI associated with coronary spasm. CRT-AEs occurred 
      in 2 women (0.7%) and included 1 transient air microembolism and 1 deep venous 
      thrombosis. There was no CRT-related mortality. In the mean follow-up period of 
      5.4 years, the MACE rate was 8.2%, including 5 deaths (1.7%), 8 nonfatal MIs 
      (2.7%), 8 nonfatal strokes (2.7%), and 11 hospitalizations for heart failure 
      (3.8%). CONCLUSIONS: In women undergoing CRT for suspected MCD, contemporary 
      testing carries a relatively low risk compared with the MACE rate in these women. 
      These results support the use of CRT by experienced operators for establishing 
      definitive diagnosis and assessing prognosis in this at-risk population. (Women's 
      Ischemia Syndrome Evaluation [WISE]; NCT00832702).
CI  - Copyright (c) 2012 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Wei, Janet
AU  - Wei J
AD  - Division of Cardiology, Women's Heart Center, Heart Institute, Cedars-Sinai 
      Medical Center, Los Angeles, California, USA.
FAU - Mehta, Puja K
AU  - Mehta PK
FAU - Johnson, B Delia
AU  - Johnson BD
FAU - Samuels, Bruce
AU  - Samuels B
FAU - Kar, Saibal
AU  - Kar S
FAU - Anderson, R David
AU  - Anderson RD
FAU - Azarbal, Babak
AU  - Azarbal B
FAU - Petersen, John
AU  - Petersen J
FAU - Sharaf, Barry
AU  - Sharaf B
FAU - Handberg, Eileen
AU  - Handberg E
FAU - Shufelt, Chrisandra
AU  - Shufelt C
FAU - Kothawade, Kamlesh
AU  - Kothawade K
FAU - Sopko, George
AU  - Sopko G
FAU - Lerman, Amir
AU  - Lerman A
FAU - Shaw, Leslee
AU  - Shaw L
FAU - Kelsey, Sheryl F
AU  - Kelsey SF
FAU - Pepine, Carl J
AU  - Pepine CJ
FAU - Merz, C Noel Bairey
AU  - Merz CN
LA  - eng
SI  - ClinicalTrials.gov/NCT00832702
GR  - N01 HV068161/HV/NHLBI NIH HHS/United States
GR  - N01HV68162/HL/NHLBI NIH HHS/United States
GR  - UL1 TR000064/TR/NCATS NIH HHS/United States
GR  - R03 AG032631/AG/NIA NIH HHS/United States
GR  - N01HV68163/HL/NHLBI NIH HHS/United States
GR  - UL1 TR000124/TR/NCATS NIH HHS/United States
GR  - 1R03AG032631/AG/NIA NIH HHS/United States
GR  - U01 HL649141/HL/NHLBI NIH HHS/United States
GR  - U01 HL649241/HL/NHLBI NIH HHS/United States
GR  - M01 RR000425/RR/NCRR NIH HHS/United States
GR  - N01-HV-68163/HV/NHLBI NIH HHS/United States
GR  - MO1-RR00425/RR/NCRR NIH HHS/United States
GR  - R01 HL090957/HL/NHLBI NIH HHS/United States
GR  - T32 HL069751/HL/NHLBI NIH HHS/United States
GR  - T32HL69751/HL/NHLBI NIH HHS/United States
GR  - N01-HV-68162/HV/NHLBI NIH HHS/United States
GR  - N01 HV068164/HV/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - JACC Cardiovasc Interv
JT  - JACC. Cardiovascular interventions
JID - 101467004
RN  - 0 (Vasodilator Agents)
RN  - G59M7S0WS3 (Nitroglycerin)
RN  - K72T3FS567 (Adenosine)
RN  - N9YNS0M02X (Acetylcholine)
SB  - IM
CIN - JACC Cardiovasc Interv. 2012 Jun;5(6):654-5. PMID: 22721661
MH  - Acetylcholine
MH  - Adenosine
MH  - Adult
MH  - Blood Flow Velocity
MH  - *Coronary Angiography/adverse effects
MH  - *Coronary Circulation
MH  - Coronary Vessels/*physiopathology
MH  - Female
MH  - Heart Failure/etiology/mortality/physiopathology
MH  - Hospitalization
MH  - Humans
MH  - *Laser-Doppler Flowmetry
MH  - *Microcirculation
MH  - Middle Aged
MH  - Myocardial Infarction/etiology/mortality/physiopathology
MH  - Myocardial Ischemia/complications/*diagnosis/mortality/physiopathology
MH  - Nitroglycerin
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Risk Assessment
MH  - Risk Factors
MH  - Stroke/etiology/mortality/physiopathology
MH  - United States
MH  - *Vasodilator Agents/adverse effects
PMC - PMC3417766
MID - NIHMS391339
COIS- Disclosure: There are no relevant conflicts of interest of any of the authors to 
      disclose.
EDAT- 2012/06/23 06:00
MHDA- 2012/10/30 06:00
PMCR- 2013/06/01
CRDT- 2012/06/23 06:00
PHST- 2011/11/03 00:00 [received]
PHST- 2012/01/13 00:00 [revised]
PHST- 2012/01/20 00:00 [accepted]
PHST- 2012/06/23 06:00 [entrez]
PHST- 2012/06/23 06:00 [pubmed]
PHST- 2012/10/30 06:00 [medline]
PHST- 2013/06/01 00:00 [pmc-release]
AID - S1936-8798(12)00295-6 [pii]
AID - 10.1016/j.jcin.2012.01.023 [doi]
PST - ppublish
SO  - JACC Cardiovasc Interv. 2012 Jun;5(6):646-53. doi: 10.1016/j.jcin.2012.01.023.