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The impact of acetylcoline-provoked coronary artery spasm on long-term prognosis of previous coronary revascularization
Abstracts / Atherosclerosis 263 (2017) e29ee110
upregulated locally and systemically after MI and promotes the influx of neutrophils and monocytes into the myocardium. We studied whether S100A8/A9 inhibition with the blocking compound ABR-238901 might reduce inflammation and improve myocardial function after MI. Methods: MI was induced by left coronary artery ligation in 8-12 weeks old mice. Echocardiography was used to assess left ventricular function. Results: Two days after MI, mice treated with ABR-238901 i.p. showed improved ejection fraction in comparison with buffer-treated animals, and had significantly decreased numbers of neutrophils and monocytes in the blood. More importantly, the presence of neutrophils and monocytes in the myocardium was reduced, leading to lower numbers of infiltrating macrophages. After 7 days of continuous treatment, cardiac function and the total counts of neutrophils and monocytes in blood and heart became similar in the two groups. However, the numbers of reparatory F4/ 80+MerTKhiLy6Clow macrophages were lower in the hearts of ABR238901 treated mice after 7 days. In contrast, we found that a balanced
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absence of previous revascularization and abnormal vasomotion to ACH provocation ; group 1-no revascularization and normal vasomotion (n¼2095, 33.0%), group 2-no revascularization and abnormal vasomotion (N¼3958, 62.4%), group 3-presence of revascularization and normal vasomotion (n¼74, 1.1%), Group 4-presence of revascularization and abnormal vasomotion (n¼219, 3.5%). Normal vasomotion was defined as no CP, no ischemic electrocardiographic changes, and no vasoconstriction; abnormal vasomtions, microvascular spasm, epicardial spasm and ACH-test inconclusive result. We investigated CP recurrence requiring follow-up angiography and major adverse cardiovascular events (MACEs) during 5 years. Results: Recurrent CP and MACEs were more frequent in patients with previous revascularization (recurrent CP, 4.5%, 7.2%, 27%, 24.2%, respectively, p<0.001; MACEs (1.2%, 1.4%, 12.2%, 8.7%, respectively, p <0.001) than in those without revascularization. In multivariate analysis, age, diabetes mellitus, fixed lesion on baseline angiography, and diltiazem use after provocation test were positive predictors for MACEs.
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treatment strategy using ABR-238901 for 3 days followed by 4 days buffer increased the numbers and the proliferative capacity of this macrophage subset, promoting cardiac repair. Conclusions: We report that 3-day blockage of S100A8/9 has beneficial effects on cardiac function in the immediate period after an MI and enhances the presence of reparatory macrophages in the myocardium.
SAG054. THE IMPACT OF ACETYLCOLINE-PROVOKED CORONARY ARTERY SPASM ON LONG-TERM PROGNOSIS OF PREVIOUS CORONARY REVASCULARIZATION Eun Mi Lee1, Hong Seog Seo2, Kyeong Ho Yun1, Cheol Ung Choi2, Jin Won Kim2, Hong Euy Lim2, Eung Ju Kim2, Seung-Woon Rha2, Chang Gyu Park2, Dong Joo Oh2. 1 Division of Cardiology, Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gyeonggi-do, Gyeonggido, South Korea; 2 Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea Aim: Previous study showed that the prognosis of acetylcholine (ACH) provoked coronary artery spasm (CAS) in patients without previous coronary revascularization was good. However, the long-term outcomes of ACH-provoked CAS in patients with previous revascularization remains unclear. Methods: This study was a retrospective, observation study with a consecutive 6346 patients undergoing ACH-provocation test. The study population was categorized according to whether the presence and
Conclusions: The long-term prognosis of ACH-provoked CAS is worse in patients with previous coronary revascularization than in those without revascularization but independent of presence of abnormal vasomotion.
SAG055. IMPROVED IN-HOSPITAL CLINICAL OUTCOMES IN PATIENTS WITH ACUTE ST-ELEVATION MYOCARDIAL INFARCTION UNDERGOING REMOTE ISCHEMIC PRECONDITIONING BEFORE PRIMARY PERCUTANEOUS CORONARY INTERVENTION Nadezda Ryazankina, Vladimir Manchurov, Elena Vasilieva, Alexander Shpektor. Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Moscow, Russia Aim: Remote ischemic preconditioning (RIPC) as an adjunct to primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction increases myocardial salvage and improves endothelial function and long-term clinical outcomes. Purpose: To determine the effect of RIPC on in-hospital clinical outcomes. Methods: Patients (n¼100) with acute ST-elevation myocardial infarction were randomized to receive primary percutaneous coronary intervention with (n¼64) or without (n¼46) remote ischemic preconditioning (RIPC: intermittent arm ischemia-reperfusion through four 5-minute- cycles of inflation/deflation with a blood-pressure cuff to 200 mm Hg). The primary endpoints were composite in-hospital cardiovascular death, heart failure, reinfarction, and arrhythmias (atrial fibrillation and ventricular tachycardia).
upregulated locally and systemically after MI and promotes the influx of neutrophils and monocytes into the myocardium. We studied whether S100A8/A9 inhibition with the blocking compound ABR-238901 might reduce inflammation and improve myocardial function after MI. Methods: MI was induced by left coronary artery ligation in 8-12 weeks old mice. Echocardiography was used to assess left ventricular function. Results: Two days after MI, mice treated with ABR-238901 i.p. showed improved ejection fraction in comparison with buffer-treated animals, and had significantly decreased numbers of neutrophils and monocytes in the blood. More importantly, the presence of neutrophils and monocytes in the myocardium was reduced, leading to lower numbers of infiltrating macrophages. After 7 days of continuous treatment, cardiac function and the total counts of neutrophils and monocytes in blood and heart became similar in the two groups. However, the numbers of reparatory F4/ 80+MerTKhiLy6Clow macrophages were lower in the hearts of ABR238901 treated mice after 7 days. In contrast, we found that a balanced
e49
absence of previous revascularization and abnormal vasomotion to ACH provocation ; group 1-no revascularization and normal vasomotion (n¼2095, 33.0%), group 2-no revascularization and abnormal vasomotion (N¼3958, 62.4%), group 3-presence of revascularization and normal vasomotion (n¼74, 1.1%), Group 4-presence of revascularization and abnormal vasomotion (n¼219, 3.5%). Normal vasomotion was defined as no CP, no ischemic electrocardiographic changes, and no vasoconstriction; abnormal vasomtions, microvascular spasm, epicardial spasm and ACH-test inconclusive result. We investigated CP recurrence requiring follow-up angiography and major adverse cardiovascular events (MACEs) during 5 years. Results: Recurrent CP and MACEs were more frequent in patients with previous revascularization (recurrent CP, 4.5%, 7.2%, 27%, 24.2%, respectively, p<0.001; MACEs (1.2%, 1.4%, 12.2%, 8.7%, respectively, p <0.001) than in those without revascularization. In multivariate analysis, age, diabetes mellitus, fixed lesion on baseline angiography, and diltiazem use after provocation test were positive predictors for MACEs.
Ă
treatment strategy using ABR-238901 for 3 days followed by 4 days buffer increased the numbers and the proliferative capacity of this macrophage subset, promoting cardiac repair. Conclusions: We report that 3-day blockage of S100A8/9 has beneficial effects on cardiac function in the immediate period after an MI and enhances the presence of reparatory macrophages in the myocardium.
SAG054. THE IMPACT OF ACETYLCOLINE-PROVOKED CORONARY ARTERY SPASM ON LONG-TERM PROGNOSIS OF PREVIOUS CORONARY REVASCULARIZATION Eun Mi Lee1, Hong Seog Seo2, Kyeong Ho Yun1, Cheol Ung Choi2, Jin Won Kim2, Hong Euy Lim2, Eung Ju Kim2, Seung-Woon Rha2, Chang Gyu Park2, Dong Joo Oh2. 1 Division of Cardiology, Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gyeonggi-do, Gyeonggido, South Korea; 2 Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea Aim: Previous study showed that the prognosis of acetylcholine (ACH) provoked coronary artery spasm (CAS) in patients without previous coronary revascularization was good. However, the long-term outcomes of ACH-provoked CAS in patients with previous revascularization remains unclear. Methods: This study was a retrospective, observation study with a consecutive 6346 patients undergoing ACH-provocation test. The study population was categorized according to whether the presence and
Conclusions: The long-term prognosis of ACH-provoked CAS is worse in patients with previous coronary revascularization than in those without revascularization but independent of presence of abnormal vasomotion.
SAG055. IMPROVED IN-HOSPITAL CLINICAL OUTCOMES IN PATIENTS WITH ACUTE ST-ELEVATION MYOCARDIAL INFARCTION UNDERGOING REMOTE ISCHEMIC PRECONDITIONING BEFORE PRIMARY PERCUTANEOUS CORONARY INTERVENTION Nadezda Ryazankina, Vladimir Manchurov, Elena Vasilieva, Alexander Shpektor. Moscow State University of Medicine and Dentistry named after A.I. Evdokimov, Moscow, Russia Aim: Remote ischemic preconditioning (RIPC) as an adjunct to primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction increases myocardial salvage and improves endothelial function and long-term clinical outcomes. Purpose: To determine the effect of RIPC on in-hospital clinical outcomes. Methods: Patients (n¼100) with acute ST-elevation myocardial infarction were randomized to receive primary percutaneous coronary intervention with (n¼64) or without (n¼46) remote ischemic preconditioning (RIPC: intermittent arm ischemia-reperfusion through four 5-minute- cycles of inflation/deflation with a blood-pressure cuff to 200 mm Hg). The primary endpoints were composite in-hospital cardiovascular death, heart failure, reinfarction, and arrhythmias (atrial fibrillation and ventricular tachycardia).