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Diffuse multi-vessel coronary artery spasm: incidence and clinical prognosis
Yae Min Park1, Seung Hwan Han, Kwang-Pil Ko
1Department of Cardiology, Gil Hospital, Gachon University of Medicine and Science, Incheon, South Korea.
International Journal of Cardiology
|January 28, 2012
Summary
Diffuse-multivessel coronary spasm is common in vasospastic angina patients. While associated with lower chest pain-free survival, its long-term prognosis is good with medical treatment.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- The clinical significance and prognosis of diffuse and multivessel coronary spasm remain largely uncharacterized.
- Vasospastic angina (VSA) is a clinical syndrome caused by dynamic stenosis of epicardial coronary arteries due to increased vascular tone.
Purpose of the Study:
- To investigate the incidence and clinical characteristics of diffuse and multivessel coronary spasm.
- To evaluate the prognosis of patients with diffuse-multivessel coronary spasm.
Main Methods:
- Prospective enrollment of patients with suspected vasospastic angina.
- Simultaneous left and right coronary angiography after ergonovine administration.
- Classification of spasm as diffuse (>20mm length) and/or multivessel (>2 epicardial arteries).
Main Results:
- Diffuse-multivessel spasm (DMS) was identified in 16.7% of patients (n=16).
- Patients with DMS showed higher rates of male gender, alcohol consumption, and elevated triglycerides, with lower HDL compared to controls.
- No significant difference in hard cardiovascular event rates was observed among groups during a mean follow-up of 41.2 months.
Conclusions:
- Diffuse-multivessel spasm is not uncommon in patients presenting with vasospastic angina.
- Despite a lower 1-year chest pain-free survival rate compared to controls, the overall prognosis for diffuse-multivessel spasm is favorable with appropriate medical management.
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