Acetylcholine Use in Modern Cardiac Catheterization Laboratories: A Systematic Review

The use of acetylcholine for the diagnosis of vasospastic angina is recommended by international guidelines. However, its intracoronary use is still off-label due to the absence of safety studies. We aimed to perform a systematic review of the literature to identify adverse events related to the int...

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Bibliographic Details
Published in:Journal of clinical medicine 2022-02, Vol.11 (4), p.1129
Main Authors: Marrone, Andrea, Pavasini, Rita, Scollo, Ennio, Gibiino, Federico, Pompei, Graziella, Caglioni, Serena, Biscaglia, Simone, Campo, Gianluca, Tebaldi, Matteo
Format: Article
Language:English
Subjects:
Angina pectoris
Cardiac arrhythmia
Cardiac catheterization
Cardiovascular disease
Clinical medicine
Coronary vessels
Heart attacks
Ischemia
Medical diagnosis
Medical imaging
Population
Review
Smooth muscle
Systematic review
Variables
Vein & artery diseases
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Summary:The use of acetylcholine for the diagnosis of vasospastic angina is recommended by international guidelines. However, its intracoronary use is still off-label due to the absence of safety studies. We aimed to perform a systematic review of the literature to identify adverse events related to the intracoronary administration of acetylcholine for vasoreactivity testing to fill this gap. We conducted a systematic review of observational studies and randomized controlled trials dealing with the intracoronary administration of acetylcholine. Articles were searched in MEDLINE (PubMed) using the MeSH strategy. Three independent reviewers determined whether the studies met the inclusion and exclusion criteria. A total of 434 articles were selected. Data concerning clinical characteristics, study population, acetylcholine dosage, and adverse effects were retrieved from the articles. Overall, 71,566 patients were included, of which only 382 (0.5%) developed one adverse event, and there were no fatal events reported (0%). Intracoronary administration of acetylcholine in the setting of coronary spasm provocation testing is safe and plays a central role in the evaluation of coronary vasomotion disorders, making it worthy of becoming a part of clinical practice in all cardiac catheterization laboratories.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm11041129