Diagnosis of coronary artery spasm by ergonovine provocation test of radial artery

We investigated the sensitivity, specificity and safety of ergonovine provocation test of radial artery in the diagnosis of coronary artery spasm (CAS). The patients who came to our hospital for chest pain from January to June 2020 as well as had coronary stenosis<50% and no radial artery stenosis, were enrolled in this study. These patients were divided into CAS group and control group after intracoronary ergonovine provocation test. All patients underwent ergonovine provocation test of radial artery, the inner diameter (D-0 and D-1) and the peak systolic velocities (PSV0 and PSV1) of the radial artery were measured by ultrasound before and after ergonovine provocation. The predictive value of ergonovine provocation test of radial artery for the diagnosis of CAS was analyzed using receiver operator characteristic (ROC) curve. There were 19 patients in the CAS group and 28 patients in the control group. Low density lipoprotein cholesterol and smoking rate were significantly higher in the CAS group than in the control group (all P<0.05), but there were no significant differences in other items (P>0.05) between the two groups. In the ergonovine provocation test of radial artery, degree of radial artery stenosis was significantly higher in the CAS group [41.50% (35.60%, 50.00%)] than in the control group [11.25% (5.15%, 23.00%)] (P=0.000), but there were no siginificant differences in D-0, PSV0 and PSV1 between the two groups (P>0.05). The area under ROC curve of ergonovine (120 mu g) provocation test of radial artery for the diagnosis of CAS was 0.912 with 95%CI: 0.792-0.975, P=0.001, cut-off of 31%, specificity of 92.86% and sensitivity of 84.21%. The ergonovine (120 mu g) provocation test of radial artery did not cause any adverse reactions. We concluded that the ergonovine provocation test of radial artery has high sensitivity, specificity and safety in the diagnosis of CAS.

Automated summary

The ergonovine provocation test of radial artery showed high sensitivity, specificity, and safety in diagnosing coronary artery spasm, with an ROC curve area of 0.912, specificity of 92.86%, and sensitivity of 84.21%.