Rehan, R.Beltrame, J.Yong, A.2023-09-182023-09-182024Journal of Cardiology, 2024; 83(1):8-160914-50871876-4738https://hdl.handle.net/2440/139499Available online 3 August 2023Coronary provocation testing is an essential diagnostic procedure when evaluating vasospastic angina. Invasive methods using acetylcholine or ergonovine are considered the current gold standard. Despite efforts from global cardiovascular institutions, current protocols vary in dosage, administration time, and procedural approach. In addition, concerns over the specificity of findings and potential complications have limited routine uptake of this procedure in clinical practice. This systematic review evaluates current diagnostic protocols, focusing on invasive provocation testing. We included studies using intracoronary provocation testing with acetylcholine or ergonovine for the assessment of coronary artery vasospasm that detailed specific elements of the procedure (dosage, administration time, etc.) and included ≥50 patients. A total of 28 articles met strict inclusion criteria. Our review highlights the heterogeneity between current diagnostic protocols for invasive provocation testing. We believe standardization of a diagnostic protocol will encourage both current and future cardiologists to incorporate such procedures in the evaluation of variant angina.en© 2023 Japanese College of Cardiology. Published by Elsevier Ltd. This is an open access article under the CC BY-NCND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).AcetylcholineCoronary artery vasospasmErgonovineIntracoronary provocation testingVasospastic anginaJournal article10.1016/j.jjcc.2023.07.0202023-09-18653079Beltrame, J. [0000-0002-4294-6510]