High-density lipoprotein cholesterol level and smoking modify the prognosis of patients with coronary vasospasm.
A cardiovascular event analysis was performed in a subset of 80 consecutive patients with vasospastic coronary artery disease. During the follow-up period (30 +/- 2 months, mean +/- SD), 9 patients had vascular accidents, including acute myocardial infarction, unstable angina, and stroke (Group A), while the remaining 71 patients were eventfree (Group B). Serum total-cholesterol, low-density lipoprotein cholesterol, and triglyceride levels were not different between the two groups at the baseline as well as after follow-up. However, the HDL-C level at baseline was significantly lower in Group A (33.5 +/- 2.6 mg/dl) than in Group B (41.9 +/- 1.7 mg/dl, p < 0.05). The HDL-C level increased significantly during the follow-up in Group B (delta HDL-C: 6.2 +/- 1.2 mg/dl, p < 0.01), but not in Group A (delta HDL-C: -3.2 +/- 2.7 mg/dl). The HDL-C level after follow-up was significantly lower in Group A (30.3 +/- 2.9 mg/dl) than in Group B (48.1 +/- 1.5 mg/dl, p < 0.01). Current smokers at the end of the follow-up period were more prevalent in Group A (67%) than in Group B (11%, p < 0.01). Cardiovascular accidents occurred more often in current smokers (6/14, 43%) at the end of the follow-up than in current nonsmokers, including quitters (3/66, 5%; p < 0.05). The HDL-C level was increased significantly (delta HDL: 6.2 +/- 1.3 mg/dl, p < 0.01) in the latter patients, but not in the former (delta HDL: -0.4 +/- 2.9 mg/dl).(ABSTRACT TRUNCATED AT 250 WORDS)
Miwa
K
K
Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University, Japan.
Fujita
M
M
Miyagi
Y
Y
Inoue
H
H
Sasayama
S
S
D000789:Angina, Unstable / Q000453:epidemiology* / Q000209:etiology; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000209:etiology; D003329:Coronary Vasospasm / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D015994:Incidence; D008074:Lipoproteins / Q000097:blood*; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking
D008074:Lipoproteins; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL