Impact of multi-vessel vasospastic angina on cardiovascular outcome

Seung Hwan Han, Kwan Yong Lee, Sung Ho Her, Youngkeun Ahn, Keun Ho Park, Dong Soo Kim, Tae Hyun Yang, Dong Ju Choi, Jung Won Suh, Hyuck Moon Kwon, Byoung Kwon Lee, Hyeon Cheol Gwon, Seung-Woon Rha, Sang Ho Jo, Kwang Pil Ko, Sang Hong Baek

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2 Citations (Scopus)

Abstract

Background and aims: Since clinical characteristics and prognosis of patients with multi-vessel vasospastic angina (VSA) are not clear, we investigated the nature and prognosis of multi-vessel VSA in Koreans. Methods: Among 2960 patients enrolled in the VA-KOREA (Vasospastic Angina in Korea) registry, 104 definite multi-vessel VSA patients, 163 single vessel VSA patients and 737 non-VSA patients were identified using the intracoronary ergonovine provocation test. Results: Multi-vessel VSA and single vessel VSA groups showed similar baseline characteristics and medical treatment on discharge, but different from the non-VSA group. The primary composite endpoint (cardiac death, acute coronary syndrome, and symptomatic new onset arrhythmia) over a 36-month follow-up period was significantly higher in the multi-vessel VSA group than in the single vessel VSA and non-VSA groups (8.7% vs. 1.8% and 1.1%, each log-rank p < 0.05, respectively). The rate of death and acute coronary syndrome of the multi-vessel VSA group was higher than in the single vessel VSA and non-VSA groups (5.8% vs. 1.2% and 0.9%, each log-rank p < 0.05, respectively). In addition, multi-vessel VSA was an independent predictor of the primary composite endpoint at 36 months (HR 8.5, 95% CI [2.6–27.2], p < 0.0001). Conclusions: Patients with multi-vessel VSA had worse clinical outcomes than single vessel VSA and non-VSA groups, suggesting that the existence of multi-vessel VSA itself is highly prognostic.

Original languageEnglish
Pages (from-to)107-113
Number of pages7
JournalAtherosclerosis
Volume281
DOIs
Publication statusPublished - 2019 Feb 1

Keywords

  • Coronary artery disease
  • Multi-vessel
  • Prognosis
  • Vasospasm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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  • Cite this

    Han, S. H., Lee, K. Y., Her, S. H., Ahn, Y., Park, K. H., Kim, D. S., Yang, T. H., Choi, D. J., Suh, J. W., Kwon, H. M., Lee, B. K., Gwon, H. C., Rha, S-W., Jo, S. H., Ko, K. P., & Baek, S. H. (2019). Impact of multi-vessel vasospastic angina on cardiovascular outcome. Atherosclerosis, 281, 107-113. https://doi.org/10.1016/j.atherosclerosis.2018.12.018