Clinical and laboratory characteristics in patients with acute myocardial infarction due to occlusive vasospasm

The purpose of this study was to determine the clinical and laboratory characteristics in patients with acute myocardial infarction (AMI) associated with coronary vasospasm.

Consecutive 231 patients with documented coronary vasospasm by ergonovine provocation test but with a normal-appearing coronary angiogram were divided into two groups, variant angina pectoris (VAP) patients (group I; n=202, 49.5 ± 11.1 years) and AMI patients (group II; n=29, 47.4 ± 11.2 years). Matched control patients were 84 AMI patients with significant stenosis (>50%) (group III; n=84, 61.2 ± 11.8 years). Although, the incidence of hypertension, diabetes mellitus, and smoking were lower in group I than in group III, there was no difference between group II and III (diabetes, 7.9% vs. 13.8% vs. 29.8%; hypertension, 19.8% vs. 24.1% vs. 41.7%; smoking 48% vs. 48.3% vs. 61.9%; respectively, p<0.01). Measured high-sensitivity C-reactive protein (hsCRP) and fibrinogen level were higher (respectively, p<0.001, p<0.001) in groups II and III (group II, 1.88 ± 2.9 mg/dl, 317.5 ± 51.2mg/dl; group III, 2.92 ± 3.9 mg/dl, 326.8 ± 107.7 mg/dl) than those in group I (0.68 ± 1.5mg/dl, 263.2 ± 70.3mg/dl). A correlation was clearly seen between fibrinogen and hsCRP (r=0.472, p<0.001).

The clinical characteristics of patients with AMI associated with spasm were similar to those with VAP, but laboratory findings were similar to those of AMI in patients with significant stenosis.