Spontaneous remission is a frequent outcome of variant angina.
To assess the prevalence of spontaneous remission in variant angina, 100 patients with this diagnosis who had undergone coronary arteriography in the hospital and a follow-up of at least 1 year were studied. Patients with coronary bypass surgery or myocardial infarction were excluded. Remission was diagnosed in 45 of the 100 patients who had been angina-free and had had no treatment for more than 3 months (mean 18.3). The other 55 patients were receiving medical treatment; 37 had been angina-free for at least 6 months (mean 22.5) and angina persisted in 18. The persistent angina group had a lower prevalence of organic coronary stenoses 70% or greater: 4 of 18 versus 22 of 45 and 22 of 37 for the other two groups (p less than 0.05), and a longer history of rest angina before admission. The remission group contained more patients (17 of 45 versus 4 of 55 [p less than 0.001]) whose attacks had been documented only by provocative testing. Rest angina recurred when calcium antagonist drugs were discontinued in 15 of 51 instances, within 1 month in 11 patients and later in 4 patients. Remission was eventually attained in 35 of the 38 patients in whom these drugs were stopped. These results indicate that remission is a frequent outcome of variant angina. This fact should be considered in the evaluation of the long-term results of treatment and in the planning of care for an individual patient.
D000328:Adult; D000788:Angina Pectoris, Variant / Q000175:diagnosis* / Q000188:drug therapy; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000175:diagnosis*; D004110:Diltiazem / Q000627:therapeutic use; D004562:Electrocardiography; D004874:Ergonovine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use; D012008:Recurrence; D012075:Remission, Spontaneous; D013997:Time Factors; D014700:Verapamil / Q000627:therapeutic use
D014700:Verapamil; D004110:Diltiazem; D009543:Nifedipine; D004874:Ergonovine