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Mental Health Status in Patients Undergoing Intracoronary Acetylcholine Provocation Test



Previous studies showed the relation of mental distress such as anxiety and depression to coronary vasoconstriction and myocardial ischemia. However, the mental health status of patients suspected to have vasospastic angina is unclear.


A total of 99 patients underwent intracoronary acetylcholine (ACh) provocation tests for the diagnosis of vasospastic angina and mental health assessment using the 12-item General Health Questionnaire (GHQ-12) and State-Trait Anxiety Inventory Form Y (STAI Y-2). Patients with binary GHQ-12 ≥ 4 were defined as having poor mental health.


Median GHQ-12 and STAI Y-2 were 3 [1, 6] and 44 [36, 50]. Forty-one (41%) patients had binary GHQ-12 ≥ 4, and 48 (48%) had positive ACh provocation tests. The number of provoked vasospasms and rate of electrocardiographic change and chest pain during ACh tests were not significantly different between patients with and without GHQ-12 ≥ 4. The incidence of positive ACh provocation test was similar between the two groups (49% vs. 48%, p = 1.00). The multivariable analysis indicated that younger age, no history of percutaneous coronary intervention and no diabetes mellitus were factors associated with higher GHQ-12 and/or STAI Y-2 scores.


More than 40% of patients who underwent ACh provocation tests had poor mental condition. No impact of mental distress on positive ACh tests was found in this study.

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We thank the participants of the study.


No funding or sponsorship was received for this study or publication of this article.


All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.


Yuichi Saito, Toshihiro Shoji, Kazuya Tateishi, Hideki Kitahara, Yoshihide Fujimoto and Yoshio Kobayashi declare that there is no conflict of interest.

Compliance with Ethics Guidelines

Informed consent was obtained from all participants, and the study was reviewed and approved by the ethical committee of Chiba University. The study was conducted in accordance with this approval and adhered to the tenets of the Declaration of Helsinki revised in 2013.

Data Availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Corresponding author

Correspondence to Yuichi Saito.

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Saito, Y., Shoji, T., Tateishi, K. et al. Mental Health Status in Patients Undergoing Intracoronary Acetylcholine Provocation Test. Adv Ther 37, 3807–3815 (2020).

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  • Acetylcholine provocation test
  • Cardiology
  • Mental stress
  • Vasospastic angina