{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T20:47:13Z","timestamp":1780087633481,"version":"3.54.0"},"reference-count":45,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,7,14]],"date-time":"2015-07-14T00:00:00Z","timestamp":1436832000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>The acetylcholine (<jats:styled-content style=\"fixed-case\">ACh<\/jats:styled-content>) spasm provocation test proposed by Yasue, Okumura et al more than a quarter\u2010century ago has become a popular method for induction of coronary spasm. This test is safe and has a low rate of complications. However, it may be limited in its ability to document attacks in daily life because previously it was the gold\u2010standard method for diagnosing active variant angina. There may be some clinical issues to modify for the next generation of cardiologists. A maximal <jats:styled-content style=\"fixed-case\">ACh<\/jats:styled-content> dose of 50\/100\u2009\u00b5g in the right coronary artery\/left coronary artery is recommended in the Japanese Circulation Society guidelines. We often experienced the usefulness of a maximal <jats:styled-content style=\"fixed-case\">ACh<\/jats:styled-content> dose of 80\/200\u2009\u00b5g for the induction of coronary spasm in some cases with low or moderate disease activity. It may be necessary to reconsider the maximal <jats:styled-content style=\"fixed-case\">ACh<\/jats:styled-content> dose as a modified method for today's real\u2010world clinical practice. In young patients with rest angina, intracoronary injection of <jats:styled-content style=\"fixed-case\">ACh<\/jats:styled-content> is less sensitive for diagnosis; in these cases, we recommend performing sequential spasm provocation tests. Especially in female patients, to document coronary artery spasm we recommend performing <jats:styled-content style=\"fixed-case\">ACh<\/jats:styled-content> tests first, instead of ergonovine tests, due to the supersensitivity of <jats:styled-content style=\"fixed-case\">ACh<\/jats:styled-content>. We also recommend supplementary use of <jats:styled-content style=\"fixed-case\">ACh<\/jats:styled-content> and ergonovine. This review summarizes our experiences with the <jats:styled-content style=\"fixed-case\">ACh<\/jats:styled-content> spasm provocation test over a period of 24 years. We have found it to be a reliable and useful method for contributing a variety of clinical information and recommend it to the next generation of cardiologists.<\/jats:p>","DOI":"10.1002\/clc.22403","type":"journal-article","created":{"date-parts":[[2015,7,14]],"date-time":"2015-07-14T20:28:14Z","timestamp":1436905694000},"page":"430-438","source":"Crossref","is-referenced-by-count":63,"title":["Overview of the Acetylcholine Spasm Provocation Test"],"prefix":"10.1002","volume":"38","author":[{"given":"Shozo","family":"Sueda","sequence":"first","affiliation":[{"name":"Department of Cardiology Ehime Niihama Prefectural Hospital  Ehime Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Kohno","sequence":"additional","affiliation":[{"name":"Department of Cardiology Ehime Niihama Prefectural Hospital  Ehime 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