Coronary spasm is associated with chronic low-grade inflammation.
BACKGROUND
Coronary spasm plays an important role in the pathogenesis of ischemic heart disease and it may be associated with low-grade inflammation.


RESULTS
Intracoronary injection of acetylcholine was done in 199 patients (99 men, 100 women, mean age, 64.5+/-11.0 years) with chest pain and normal coronary angiograms. According to the results of the provocation test, the study subjects were divided into 2 groups: the spasm group of 112 patients and the non-spasm group of 87 patients. Clinical data including high-sensitivity C-reactive protein (hs-CRP) and other coronary risk factors were compared between the 2 groups. Serum levels of hs-CRP were significantly higher in the spasm group than in the non-spasm group (median: 1.2 mg/L vs 0.5 mg/L, p<0.005). Multivariate analysis showed that hs-CRP and smoking history were independently associated with coronary spasm with an odds ratio of 2.28 (p=0.027) and 2.25 (p=0.037), respectively, with a hs-CRP value of > or = 2 mg/L as cutoff point.


CONCLUSIONS
Minor elevations of the serum hs-CRP level are significantly associated with coronary spasm, suggesting that chronic low-grade inflammation may be involved in the pathogenesis of coronary spasm.
Itoh
Teruhiko
T
Division of Cardiology, Kumamoto Kinou Hospital, Kumamoto Aging Research Institute, Kumamoto, Japan. teruito@m6.dion.ne.jp
Mizuno
Yuji
Y
Harada
Eisaku
E
Yoshimura
Michihiro
M
Ogawa
Hisao
H
Yasue
Hirofumi
H
D000109:Acetylcholine; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D016022:Case-Control Studies; D002637:Chest Pain / Q000188:drug therapy; D002908:Chronic Disease; D003329:Coronary Vasospasm / Q000097:blood* / Q000139:chemically induced / Q000209:etiology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D005996:Nitroglycerin / Q000627:therapeutic use; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014665:Vasodilator Agents / Q000627:therapeutic use
D015415:Biomarkers; D014665:Vasodilator Agents; D002097:C-Reactive Protein; D005996:Nitroglycerin; D000109:Acetylcholine