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Statistical analysis of clinical risk factors for coronary artery spasm: identification of the most important
1Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Insights
Smoking is the primary risk factor for coronary artery spasm (CAS), a key cause of acute ischemic events. This study identified smoking as the most significant predictor in patients with typical angina or previous myocardial infarction.
Area of Science:
- Cardiology
- Vascular Medicine
- Risk Factor Analysis
Background:
- Coronary artery spasm (CAS) is a significant factor in acute ischemic events.
- CAS is closely associated with coronary atherosclerosis.
- Identifying key risk factors for CAS is crucial for patient management.
Purpose of the Study:
- To determine the most significant risk factor for coronary artery spasm (CAS).
- To investigate the relationship between CAS and various coronary risk factors.
Main Methods:
- Analyzed 3000 patients undergoing coronary cineangiography with ergonovine maleate testing.
- Stratified patients into groups based on typical angina or old myocardial infarction.
- Subdivided groups by presence of fixed organic stenosis (FOS) and CAS.
- Evaluated eight coronary risk factors using multiple regression analysis.
Main Results:
- Smokers showed a significantly higher prevalence in CAS(+) subgroups compared to CAS(-) subgroups (p<0.01).
- No correlation was found between smoking and fixed organic stenosis.
- Multiple regression analysis revealed a positive correlation between smoking and CAS(+).
- Serum high-density lipoprotein cholesterol levels also showed a positive correlation with CAS(+) (p<0.01).
Conclusions:
- Smoking is the most significant risk factor for discriminating between patients with and without coronary artery spasm.
- Serum high-density lipoprotein cholesterol levels are also positively correlated with coronary artery spasm.
Abstract:
Coronary artery spasm plays an important role in acute ischemic events, and it has a close relationship with coronary atherosclerosis. Thus we attempted to determine the most significant risk factor for coronary artery spasm. Among 3000 consecutive patients who underwent coronary cineangiography with ergonovine maleate testing, 330 with typical angina pectoris (group 1) and 294 with old myocardial infarction (group 2) were studied. We divided each group into three or four subgroups according to the presence of fixed organic stenosis (FOS+) or a positive reaction to ergonovine maleate (coronary artery spasm [CAS]+). We examined the relationship between coronary artery spasm and eight coronary risk factors: age, sex, hypertension, diabetes mellitus, smoking, and serum cholesterol, uric acid, and high-density lipoprotein cholesterol levels. The proportion of smokers in the subgroups with CAS(+) was significantly higher than in the subgroups with CAS(-)(p less than 0.01). There was no correlation between smoking and fixed organic stenosis. According to the results of multiple regression analysis, there was a positive correlation between smoking and CAS(+) and between serum high-density lipoprotein cholesterol levels and CAS(+)(p less than 0.01). Thus we concluded that smoking is the most significant risk factor in discriminating between patients with and without coronary artery spasm.