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[Significance of coronary risk factors and coronary arteriosclerosis for coronary vasospasm]
1First Department of Internal Medicine, Asahikawa Medical College, Hokkaido.
Insights
Coronary spasm is linked to coronary arteriosclerosis and risk factors like smoking and family history. These factors, along with gender and age, influence spasm development, particularly in males.
Area of Science:
- Cardiology
- Vascular Biology
- Clinical Investigation
Context:
- Investigated clinical significance of coronary arteriosclerosis and risk factors in patients experiencing coronary spasm.
- Utilized acetylcholine provocation test in 140 patients (85 males, 55 females) presenting with chest pain.
- Categorized patients into positive, borderline (coronary contractive), and negative groups based on test results.
Purpose:
- To explore the relationship between coronary arteriosclerosis, various risk factors, and the occurrence of coronary spasm.
- To identify demographic and lifestyle factors associated with coronary spasm.
- To evaluate the role of coronary sclerosis index and specific risk factors in spasm development.
Summary:
- Coronary spasm was observed in 57.9% of patients (coronary contractive group).
- Higher coronary sclerosis index noted in contractive groups, especially in males over 60.
- Smoking history (both sexes) and family history (females) emerged as significant risk factors for coronary spasm.
Impact:
- Suggests that coronary sclerosis degree, gender, and age are determinants of coronary spasm.
- Highlights smoking habits and family history as key risk factors, informing preventative strategies.
- Provides insights into the pathophysiology of coronary spasm, aiding clinical diagnosis and management.
Abstract:
The clinical significance of coronary arteriosclerosis and coronary risk factors was investigated in patients with coronary spasm. Coronary spasm induction test with acetylcholine was performed in 140 consecutive patients (85 males and 55 females) with chest pain in our hospital. The patients were divided into positive, borderline, and negative groups according to the results of the test. The positive and borderline groups were categorized as the coronary contractive group. The coronary sclerosis index was used to evaluate the degree of coronary arteriosclerosis. Coronary risk factors were evaluated in terms of hypertension, diabetes mellitus, hyperlipidemia, obesity, history of smoking and drinking, and family history of cardiovascular events. Patients could be divided into 34.3% in the positive group and 23.6% in the borderline group, i.e. 57.9% in the coronary contractive group, and 42.1% in the negative group. There were more males than females in both positive and coronary contractive groups. The proportion of males in the coronary contractive group was higher in patients over 60 years of age than in patients under 60. In contrast, the proportion of females was higher in patients under 60 than in patients over 60. In male patients, the coronary sclerosis indices in the positive, borderline, and coronary contractive groups were higher than those in the negative group. The indices in female patients in the positive and coronary contractive groups were higher than the index in the negative group. There were no differences in terms of the presence or absence, or the degree of organic stenosis between spastic sites and nonspastic branches in the positive group. The history of smoking in male patients was significantly more common in the positive group than in the negative group. The family history was more relevant in female patients in the positive or coronary contractive group compared to the negative group. Moreover, the history of smoking in the coronary contractive group was significantly more common than that in the negative group. The development of coronary spasm may be determined, at least in part, by the degree of coronary sclerosis as well as by gender and age. Smoking habits in both sexes and family history in females are proposed as the most important risk factors for coronary spasm.