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Effect of Significant Coronary Artery Stenosis on Prognosis in Patients with Vasospastic Angina: A Propensity

Hyun-Jin Kim1, Min-Ho Lee2, Sang-Ho Jo3

  • 1Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Seoul 04763, Korea.

Journal of Clinical Medicine
|August 7, 2021
PubMed

Insights

Coronary artery stenosis significantly worsens clinical outcomes for patients with vasospastic angina (VA). This finding highlights the need to manage atherosclerosis risk factors alongside vasospasm in VA patients.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Clinical Outcomes Research

Background:

  • Vasospastic angina (VA) is a functional coronary artery disease.
  • VA typically presents with normal coronary arteries but can coexist with significant coronary artery stenosis.
  • The impact of concurrent coronary artery stenosis on VA patient outcomes is not fully understood.

Purpose of the Study:

  • To investigate the effect of significant coronary artery stenosis on clinical outcomes in patients diagnosed with vasospastic angina.
  • To determine if coronary artery stenosis independently influences adverse events in VA patients.

Main Methods:

  • Prospective multicenter registry data analysis.
  • Classification of VA patients into "significant stenosis" and "no significant stenosis" groups.
  • One-year composite clinical events and acute coronary syndrome (ACS) prevalence assessment.
  • Propensity score matching to control for confounding factors.

Main Results:

  • The one-year composite clinical events rate was significantly higher in the significant stenosis group (5.8%) compared to the no significant stenosis group (1.4%).
  • Prevalence of ACS was significantly greater in the significant stenosis group (4.8% vs. 0.9%).
  • Significant stenosis remained independently associated with adverse outcomes, including a 6.67-fold increased risk of ACS, after propensity score matching.

Conclusions:

  • Significant coronary artery stenosis is associated with increased adverse clinical outcomes and ACS risk in VA patients.
  • Management strategies for VA should address both vasospasm and underlying atherosclerosis.
  • Controlling traditional atherosclerosis risk factors is crucial for improving long-term prognosis in VA patients with significant stenosis.

Keywords:
acute coronary syndromecoronary artery stenosisvasospastic angina

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