Incidence of spontaneous and provoked coronary spasms after percutaneous transluminal coronary angioplasty.
We studied the incidence of spontaneous and ergonovine-induced coronary arterial spasm during repeat coronary angiography in 96 consecutive patients with single-vessel disease who had undergone successful angioplasty. Follow-up angiography was performed after a mean of 6 months (1-8 months). Sixty patients demonstrated no restenosis and in 36 patients restenosis (greater than 50% restenosis) occurred. Spasms of the arteries at the site of dilatation were significantly (P less than 0.001) more frequent in patients with restenosis (18/36; 50%) than in patients without restenosis (4/60; 7%). Before angioplasty, no differences were found in the clinical characteristics between the two groups. Likewise, the morphologic results of angioplasty were identical. Despite long-term treatment with nifedipine (30-60 mg daily) and aspirin (0.5 g daily), 14 of 18 patients with restenosis and coronary spasm suffered from spontaneous angina, as compared to only 3 of 18 patients with restenosis without demonstrable spasm. Three of the 4 patients without restenosis but with detectable spasm were also symptomatic. Thus our findings suggest that spasm of the coronary arteries achieves some importance as a pathophysiological factor for recurrence following coronary angioplasty.
Leisch
F
F
I. Medizinische Abteilung, Allgemeines Krankenhaus der Stadt Linz, Austria.
Schützenberger
W
W
Kerschner
K
K
Hofmann
R
R
Herbinger
W
W
D000787:Angina Pectoris / Q000209:etiology; D000800:Angioplasty, Balloon; D003327:Coronary Disease / Q000628:therapy*; D003329:Coronary Vasospasm / Q000209:etiology*; D004562:Electrocardiography; D004874:Ergonovine / Q000031:analogs & derivatives; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence
D004874:Ergonovine