Nitrates vs. Other Types of Vasodilators and Clinical Outcomes in Patients with Vasospastic Angina: A Propensity Score-Matched Analysis

Hyun Jin Kim, Sang Ho Jo, Min Ho Lee, Won Woo Seo, Hack Lyoung Kim, Kwan Yong Lee, Tae Hyun Yang, Sung Ho Her, Byoung Kwon Lee, Keun Ho Park, Youngkeun Ahn, Seung Woon Rha, Hyeon Cheol Gwon, Dong Ju Choi, Sang Hong Baek

Research output: Contribution to journalArticlepeer-review

Abstract

Although vasodilators are widely used in patients with vasospastic angina (VA), few studies have compared the long-term prognostic effects of different types of vasodilators. We investigated the long-term effects of vasodilators on clinical outcomes in VA patients according to the type of vasodilator used. Study data were obtained from a prospective multicenter registry that included patients who had symptoms suggestive of VA. Patients were classified into two groups according to use of nitrates (n = 239) or other vasodilators (n = 809) at discharge. The composite clinical events rate, including acute coronary syndrome (ACS), cardiac death, new-onset arrhythmia (including ventricular tachycardia and ventricular fibrillation), and atrioventricular block, was significantly higher in the nitrates group (5.3% vs. 2.2%, p = 0.026) during one year of follow-up. Specifically, the prevalence of ACS was significantly more frequent in the nitrates group (4.3% vs. 1.5%, p = 0.024). After propensity score matching, the adverse effects of nitrates remained. In addition, the use of nitrates at discharge was independently associated with a 2.69-fold increased risk of ACS in VA patients. In conclusion, using nitrates as a vasodilator at discharge can increase the adverse clinical outcomes in VA patients at one year of follow-up. Clinicians need to be aware of the prognostic value and consider prescribing other vasodilators.

Original languageEnglish
Article number3250
JournalJournal of Clinical Medicine
Volume11
Issue number12
DOIs
Publication statusPublished - 2022 Jun 1
Externally publishedYes

Keywords

  • acute coronary syndrome
  • nitrate
  • vasodilator
  • vasospastic angina

ASJC Scopus subject areas

  • Medicine(all)

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