Acetylcholine-Provoked Coronary Spasm at Site of Significant Organic Stenosis Predicts Poor Prognosis in Patients With Coronary Vasospastic Angina

Journal of the American College of Cardiology
Masanobu IshiiHisao Ogawa

Abstract

Coronary artery spasm contributes to the pathogenesis of variant angina and ischemic heart disease and may play a role in the progression of atherosclerosis. It is unclear whether the location of spasm is related to outcome. This study compared the clinical features and prognosis of patients with coronary spasm at the site of significant atherosclerotic stenosis with patients with spasm at sites without stenosis or nonsignificant stenosis. This was a retrospective, observational study of 1,877 consecutive patients with typical or atypical angina-like chest pain undergoing acetylcholine (ACh)-provocation testing. A total of 1,760 patients were eligible for analysis. ACh-provoked coronary spasm and significant organic stenosis were observed in 873 and 358 patients, respectively. In patients with significant atherosclerotic stenosis, ACh-positive patients (n = 233) were younger and without diabetes mellitus compared with nonspasm patients (n = 125). In patients without organic stenosis, ACh-positive patients (n = 640) were older, had dyslipidemia, and were more likely to have a family history of ischemic heart disease than nonspasm patients (n = 762). Multiple logistic regression analysis identified ST-segment elevation during ang...Continue Reading

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Citations

Sep 5, 2015·Journal of the American College of Cardiology·Jaskanwal D SaraAmir Lerman
Apr 16, 2016·Journal of the American College of Cardiology·Masanobu IshiiHisao Ogawa
Apr 16, 2016·Journal of the American College of Cardiology·Luis Ortega-PazSalvatore Brugaletta
Jul 9, 2016·International Journal of Cardiology·Masanobu IshiiHisao Ogawa
May 22, 2016·Journal of the American Heart Association·Masanobu IshiiHisao Ogawa
Oct 5, 2019·Nature Reviews. Cardiology·Thomas M WaterburyRajiv Gulati
Mar 20, 2016·American Journal of Physiology. Heart and Circulatory Physiology·Tomonori AkasakaHisao Ogawa
Sep 25, 2016·American Journal of Physiology. Heart and Circulatory Physiology·Tomonori AkasakaSeiji Hokimoto
Sep 11, 2020·Computational and Mathematical Methods in Medicine·Baoliang ZhuJing Yan
Jun 25, 2018·Heart and Vessels·Ken WatanabeMasafumi Watanabe
Oct 28, 2020·Cardiovascular Intervention and Therapeutics·Satoru SuzukiKenichi Tsujita
Nov 16, 2019·Circulation Reports·Noriaki MoriyamaShigeru Saito
Mar 20, 2021·JACC. Cardiovascular Interventions·Kensuke NishimiyaHiroaki Shimokawa
Feb 19, 2021·Circulation Journal : Official Journal of the Japanese Circulation Society·Masakazu YamagishiUNKNOWN Japanese Circulation Society Working Group
Jul 9, 2021·Nature Reviews. Cardiology·Edoardo BerteroChristoph Maack

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