{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T18:32:39Z","timestamp":1786559559347,"version":"build-2736575974"},"reference-count":23,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T00:00:00Z","timestamp":1775952000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A substantial proportion of patients with angina and\/or ischemia are found to have non\u2010obstructive coronary arteries (ANOCA\/INOCA). Their symptoms can sometimes be explained by coronary microvascular dysfunction and\/or vasospasm. Selecting patients for acetylcholine testing remains challenging, and the procedure is not trivial in terms of logistics, cost, and risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The aim of this single\u2010center retrospective study was to identify predictors of coronary spasm and define features that may help avoid unnecessary testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All consecutive ANOCA\/INOCA patients who underwent intracoronary acetylcholine testing between February 2022 and June 2025 at a tertiary university hospital were included. Baseline clinical variables were analyzed using multivariable logistic regression. A 3\u2010variable exploratory model was then constructed to identify independent predictors of unnecessary acetylcholine testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the study population (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200947), 46.8% demonstrated a positive spasm response. In the multivariable model, age\u2009\u2265\u200960 years (OR\u2009=\u20090.11, 95% CI [0.02\u20130.80];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029) and dyslipidaemia (OR\u2009=\u20090.12, 95% CI [0.01\u20130.99];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.049) were independently associated with lower odds of spasm, whereas IMR\u2009\u2265\u200925 showed a non\u2010significant association with lower odds of spasm (OR\u2009=\u20090.10, 95% CI [0.005\u20131.9];\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.128). The 3\u2010variable exploratory model showed good discrimination (AUC 0.83, 95% CI 0.68\u20130.97) and was associated with a reduction in overall ACh testing by 45.2% in complete\u2010case analysis, with a sensitivity of 85.7%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dyslipidaemia and age\u2009\u2265\u200960 years are independently associated with lower odds of acetylcholine\u2010induced spasm. This model showed good discrimination and may help inform strategies to reduce unnecessary acetylcholine testing, although these findings require external validation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70628","type":"journal-article","created":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T04:53:02Z","timestamp":1776055982000},"page":"14-20","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical and Physiological Predictors of Acetylcholine\u2010Induced Coronary Spasm in ANOCA\/INOCA Patients: A Retrospective Cohort Study"],"prefix":"10.1002","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9985-0776","authenticated-orcid":false,"given":"Jeremie","family":"Buri","sequence":"first","affiliation":[{"name":"Department of Cardiology Lausanne University Hospital (CHUV) Lausanne 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