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[The relation between coronary vasospasm and coronary obstructive lesions in patients with variant angina]
1Cardiovascular Institute of the Chinese Academy of Medical Sciences, Fu Wai Cardiovascular Hospital, Beijing.
Insights
Coronary vasospasm is linked to coronary artery disease severity. This study found vasospasm is most common in arteries with 75%-90% stenosis, particularly the left anterior descending artery.
Area of Science:
- Cardiology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Variant angina is characterized by coronary vasospasm.
- The relationship between vasospasm and obstructive coronary lesions requires further investigation.
Purpose of the Study:
- To explore the association between coronary vasospasm and the presence and severity of coronary obstructive lesions.
- To determine if coronary vasospasm incidence correlates with stenosis degree.
Main Methods:
- Retrospective review of 38 patients diagnosed with variant angina.
- Coronary arteriography was performed to assess coronary artery anatomy and identify obstructive lesions.
- Analysis of vasospasm occurrence in relation to stenosis severity and affected coronary arteries.
Main Results:
- Significant coronary artery disease (>= 50% stenosis) was present in 63.2% of patients.
- Coronary vasospasm incidence increased with stenosis severity, peaking at 75%-90% stenosis.
- The left anterior descending artery (LAD) was the most frequently involved artery in vasospasm, especially in severe stenosis cases.
Conclusions:
- Coronary vasospasm is common in patients with variant angina and obstructive coronary lesions.
- The severity of coronary stenosis directly correlates with the likelihood of coronary vasospasm.
- Severe stenosis of the LAD is frequently associated with coronary vasospasm.
Abstract:
A series of 38 patients with variant angina in whom coronary arteriography was performed was reviewed to investigate the relation between coronary vasospasm and coronary obstructive lesions. 10 of the 38 (26.3%) patients had completely normal coronary arteriograms; 4 (10.5%) had insignificant coronary artery disease (< 50% stenosis); 24 (63.2%) had significant (> or = 50% stenosis) coronary artery disease, including single vessel disease in 12 cases, multiple vessel disease in 11 cases and left main trunk disease in one case. The results of this study showed that the incidence of coronary vasospasm increased with the severity of coronary stenosis and was highest at 75%-90% stenosis of the ischemia-related artery in those patients with significant coronary disease. In this study of 38 patients, coronary vasospasm involved the left anterior descending artery (LAD) in 25 patients (65.8%), right coronary artery (RCA) in 10 (26.3%) and left circumflex artery (LCX) in 2 (5.3%), but in patients with in significant stenosis (< 50%), LAD was involved in 50.0%, RCA in 42.9% and LCX in 7.1%. These results indicate that coronary vasospasm occurs frequently in patients with severe stenosis of the LAD.