Clinical outcome according to spasm type of single coronary artery provoked by intracoronary ergonovine tests in patients without significant organic stenosis

Dae Won Kim, Sung Ho Her, Youngkeun Ahn, Dong IL Shin, Seung Hwan Han, Dong Soo Kim, Dong Ju Choi, Hyuck Moon Kwon, Hyeon Cheol Gwon, Sang Ho Jo, Seung-Woon Rha, Sang Hong Baek

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background This study aimed to evaluate clinical implications of single vessel coronary spasm provoked by intracoronary ergonovine provocation test in Korean population. Method A total of 1248 patients who presented with single vessel coronary artery spasm induced by intracoronary ergonovine provocation test, excluding 1712 with negative spasms, multiple and mixed coronary artery spasms and missing data among 2960 patients in the VA-KOREA (Vasospastic Angina in Korea) registry, were classified into diffuse (n = 705) and focal (n = 543) groups. Results The 24-month incidences of a composite primary endpoints (cardiac death, new-onset arrhythmia, and acute coronary syndrome) were determined. Over a median follow-up of 30 months, the composite primary end point occurred more frequently in the focal type patients than in the diffuse type patients (primary endpoint: adjusted hazard ratio [aHR], 1.658; 95% confidence interval [CI] 1.272 to 2.162, P < 0.001). Especially, unstable angina in ACS components played a major role in this effect (hazard ratio [HR], 2.365; 95% confidence interval [CI] 1.100 to 5.087, P = 0.028). Conclusion Focal type of single vessel coronary artery spasm in vasospastic angina (VSA) patients is found to be associated with worse clinical outcomes. It is thought that the effect is stemmed from unstable angina among ACS rather than the other components of primary endpoint. Therefore, focal type of single vessel coronary artery spasm in patients with VSA should be more carefully assessed and managed with appropriate medication.

Original languageEnglish
Pages (from-to)6-12
Number of pages7
JournalInternational Journal of Cardiology
Volume252
DOIs
Publication statusPublished - 2018 Feb 1

Fingerprint

Ergonovine
Spasm
Coronary Vessels
Pathologic Constriction
Unstable Angina
Confidence Intervals
Acute Coronary Syndrome
Korea
Registries
Cardiac Arrhythmias
Incidence
Population

Keywords

  • Focal spasm
  • Single vessel spasm
  • Vasospastic angina

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Clinical outcome according to spasm type of single coronary artery provoked by intracoronary ergonovine tests in patients without significant organic stenosis. / Kim, Dae Won; Her, Sung Ho; Ahn, Youngkeun; Shin, Dong IL; Han, Seung Hwan; Kim, Dong Soo; Choi, Dong Ju; Kwon, Hyuck Moon; Gwon, Hyeon Cheol; Jo, Sang Ho; Rha, Seung-Woon; Baek, Sang Hong.

In: International Journal of Cardiology, Vol. 252, 01.02.2018, p. 6-12.

Research output: Contribution to journalArticle

Kim, Dae Won ; Her, Sung Ho ; Ahn, Youngkeun ; Shin, Dong IL ; Han, Seung Hwan ; Kim, Dong Soo ; Choi, Dong Ju ; Kwon, Hyuck Moon ; Gwon, Hyeon Cheol ; Jo, Sang Ho ; Rha, Seung-Woon ; Baek, Sang Hong. / Clinical outcome according to spasm type of single coronary artery provoked by intracoronary ergonovine tests in patients without significant organic stenosis. In: International Journal of Cardiology. 2018 ; Vol. 252. pp. 6-12.
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abstract = "Background This study aimed to evaluate clinical implications of single vessel coronary spasm provoked by intracoronary ergonovine provocation test in Korean population. Method A total of 1248 patients who presented with single vessel coronary artery spasm induced by intracoronary ergonovine provocation test, excluding 1712 with negative spasms, multiple and mixed coronary artery spasms and missing data among 2960 patients in the VA-KOREA (Vasospastic Angina in Korea) registry, were classified into diffuse (n = 705) and focal (n = 543) groups. Results The 24-month incidences of a composite primary endpoints (cardiac death, new-onset arrhythmia, and acute coronary syndrome) were determined. Over a median follow-up of 30 months, the composite primary end point occurred more frequently in the focal type patients than in the diffuse type patients (primary endpoint: adjusted hazard ratio [aHR], 1.658; 95{\%} confidence interval [CI] 1.272 to 2.162, P < 0.001). Especially, unstable angina in ACS components played a major role in this effect (hazard ratio [HR], 2.365; 95{\%} confidence interval [CI] 1.100 to 5.087, P = 0.028). Conclusion Focal type of single vessel coronary artery spasm in vasospastic angina (VSA) patients is found to be associated with worse clinical outcomes. It is thought that the effect is stemmed from unstable angina among ACS rather than the other components of primary endpoint. Therefore, focal type of single vessel coronary artery spasm in patients with VSA should be more carefully assessed and managed with appropriate medication.",
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T1 - Clinical outcome according to spasm type of single coronary artery provoked by intracoronary ergonovine tests in patients without significant organic stenosis

AU - Kim, Dae Won

AU - Her, Sung Ho

AU - Ahn, Youngkeun

AU - Shin, Dong IL

AU - Han, Seung Hwan

AU - Kim, Dong Soo

AU - Choi, Dong Ju

AU - Kwon, Hyuck Moon

AU - Gwon, Hyeon Cheol

AU - Jo, Sang Ho

AU - Rha, Seung-Woon

AU - Baek, Sang Hong

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background This study aimed to evaluate clinical implications of single vessel coronary spasm provoked by intracoronary ergonovine provocation test in Korean population. Method A total of 1248 patients who presented with single vessel coronary artery spasm induced by intracoronary ergonovine provocation test, excluding 1712 with negative spasms, multiple and mixed coronary artery spasms and missing data among 2960 patients in the VA-KOREA (Vasospastic Angina in Korea) registry, were classified into diffuse (n = 705) and focal (n = 543) groups. Results The 24-month incidences of a composite primary endpoints (cardiac death, new-onset arrhythmia, and acute coronary syndrome) were determined. Over a median follow-up of 30 months, the composite primary end point occurred more frequently in the focal type patients than in the diffuse type patients (primary endpoint: adjusted hazard ratio [aHR], 1.658; 95% confidence interval [CI] 1.272 to 2.162, P < 0.001). Especially, unstable angina in ACS components played a major role in this effect (hazard ratio [HR], 2.365; 95% confidence interval [CI] 1.100 to 5.087, P = 0.028). Conclusion Focal type of single vessel coronary artery spasm in vasospastic angina (VSA) patients is found to be associated with worse clinical outcomes. It is thought that the effect is stemmed from unstable angina among ACS rather than the other components of primary endpoint. Therefore, focal type of single vessel coronary artery spasm in patients with VSA should be more carefully assessed and managed with appropriate medication.

AB - Background This study aimed to evaluate clinical implications of single vessel coronary spasm provoked by intracoronary ergonovine provocation test in Korean population. Method A total of 1248 patients who presented with single vessel coronary artery spasm induced by intracoronary ergonovine provocation test, excluding 1712 with negative spasms, multiple and mixed coronary artery spasms and missing data among 2960 patients in the VA-KOREA (Vasospastic Angina in Korea) registry, were classified into diffuse (n = 705) and focal (n = 543) groups. Results The 24-month incidences of a composite primary endpoints (cardiac death, new-onset arrhythmia, and acute coronary syndrome) were determined. Over a median follow-up of 30 months, the composite primary end point occurred more frequently in the focal type patients than in the diffuse type patients (primary endpoint: adjusted hazard ratio [aHR], 1.658; 95% confidence interval [CI] 1.272 to 2.162, P < 0.001). Especially, unstable angina in ACS components played a major role in this effect (hazard ratio [HR], 2.365; 95% confidence interval [CI] 1.100 to 5.087, P = 0.028). Conclusion Focal type of single vessel coronary artery spasm in vasospastic angina (VSA) patients is found to be associated with worse clinical outcomes. It is thought that the effect is stemmed from unstable angina among ACS rather than the other components of primary endpoint. Therefore, focal type of single vessel coronary artery spasm in patients with VSA should be more carefully assessed and managed with appropriate medication.

KW - Focal spasm

KW - Single vessel spasm

KW - Vasospastic angina

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