Comparison of Two-Year Outcomes of Acute Myocardial Infarction Caused by Coronary Artery Spasm Versus that Caused by Coronary Atherosclerosis

Ju Yeol Baek, Byoung Geol Choi, Seung Woon Rha, Cheol Ung Choi, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh, Tae Hoon Ahn, Kiyuk Chang, Shung Chull Chae, Seung Ho Hur, Kwang Soo Cha, In Ho Choi, Hyo Soo Kim, Hyeon Cheol Gwon, Young Jo Kim, Seok Kyu Oh, Jei Keon Chae, In Whan Seong, Kyung Kook HwangChong Jin Kim, Jung Han Yoon, Jin Yong Hwang, Doo Il Kim, Seung Jae Joo, Myung ho Jeong

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Abstract

The study compared the 2-year outcomes of patients diagnosed with acute myocardial infarction (AMI) triggered by coronary artery atherosclerosis and AMI caused by coronary artery spasm. A total of 36,797 patients in the Korea AMI Registry were grouped into 2 categories—(1) AMI due to coronary artery spasm without stenotic lesion (CAS-AMI, n = 484); and (2) AMI induced by coronary artery atherosclerosis (CAA-AMI, n = 36,313). The major clinical outcomes of the 2 groups were compared over a 2-year clinical follow-up period. Major adverse cardiac events (MACE) were defined as the composite of total death, nonfatal myocardial infarction, and repeat revascularization. The incidence of MACE (7.1% vs 11.1%; p = 0.007) and repeat revascularization (0.4% vs 4.2%; p <0.001) in the CAS-AMI group were significantly lower than in the CAA-AMI group at 2 years. However, the incidence of total death and nonfatal myocardial infarction was similar in both the groups. Aborted cardiac arrest was strongly associated with 2-year mortality in the CAS-AMI group (hazard ratios 13.5, 95% confidence interval 5.34 to 34.15, p <0.001) The incidence of MACE in CAS-AMI patients was significantly lower than in the CAA-AMI group of patients up to 2 years due to the relatively lower rate of repeat revascularization in CAS-AMI patients. However, the incidence of total death or nonfatal myocardial infarction in CAS-AMI patients was not different from that of patients with CAA-AMI.

Original languageEnglish
Pages (from-to)1493-1500
Number of pages8
JournalAmerican Journal of Cardiology
Volume124
Issue number10
DOIs
Publication statusPublished - 2019 Nov 15

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Baek, J. Y., Choi, B. G., Rha, S. W., Choi, C. U., Park, C. G., Seo, H. S., Oh, D. J., Ahn, T. H., Chang, K., Chae, S. C., Hur, S. H., Cha, K. S., Choi, I. H., Kim, H. S., Gwon, H. C., Kim, Y. J., Oh, S. K., Chae, J. K., Seong, I. W., ... Jeong, M. H. (2019). Comparison of Two-Year Outcomes of Acute Myocardial Infarction Caused by Coronary Artery Spasm Versus that Caused by Coronary Atherosclerosis. American Journal of Cardiology, 124(10), 1493-1500. https://doi.org/10.1016/j.amjcard.2019.08.019