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Int J Cardiol. 2013 Jul 31;167(2):398-402. doi: 10.1016/j.ijcard.2011.12.106. Epub 2012 Jan 24.

Diffuse multi-vessel coronary artery spasm: incidence and clinical prognosis.

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  • 1Department of Cardiology, Gil Hospital, Gachon University of Medicine and Science, Incheon, South Korea.

Abstract

BACKGROUND:

The incidence and clinical prognosis of diffuse and multivessel coronary spasm has not been reported.

METHODS:

Patients with suspected vasospastic angina were prospectively enrolled. Left and right coronary angiogram was performed simultaneously after intravenous ergonovine injection. Spasm (>70% luminal narrowing) was sub-classified as diffuse (more than 20mm length), multivessel (more than 2 epicardial arteries). Clinical characteristics and prognosis were analyzed.

RESULTS:

Patients (96 consecutive patients, 56 males, mean age 48 years) were divided into 3 groups: diffuse-multivessel spasm (group I, n=16, 16.7%), other types of spasm (group II, n=12, 12.5%) and control group (group III, n=68, 70.8%). The rates of males, alcohol drinkers and the mean triglyceride were higher, and high density lipoprotein was lower in group I compared to group III (all p<0.05), but similar to group II (all p=NS). Hard cardiovascular event rates did not differ among groups (one cardiac arrest but successful resuscitation in group I, one non-fatal myocardial infarction in group III) during follow up periods (mean, 41.2 ± 13.7 months). Chest pain free survivals during 1 year were lower in group I (66.7%) compared to group III (90%), but similar to group II (58.3%) (group I vs III, p<0.05 and group I vs II, p=NS).

CONCLUSIONS:

Diffuse-multivessel spasm was not rare in patients with vasospastic angina and its prognosis is pretty good similar to patients with previously known variant angina with recommended medical treatment.

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

PMID:
22280554
[PubMed - indexed for MEDLINE]
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