High incidence of repeat anginal attacks despite treatment with calcium-channel blockers in patients with coronary spastic angina.
BACKGROUND
Calcium-channel blockers (CCBs) are highly effective in suppressing coronary spasm and are widely used as the standard therapy for coronary spastic angina, but it is unclear if CCB treatment completely suppresses the symptoms.


RESULTS
The clinical course of the symptoms caused by coronary spasm was investigated in patients taking CCBs: 90 patients were evaluated and 80 patients were followed. The mean follow-up period was 1,796+/-1,169 days. There were no cardiac deaths, but 3 patients were admitted to the hospital, 1 because of the onset of non-Q wave myocardial infarction and 2 because of repeat anginal attacks. In those 2 patients, medical therapy was discontinued at their discretion. In the follow-up analysis, we found that the incidence of symptoms caused by repeat anginal attacks was 37.0% (27/73) in the first year and was increasing every year.


CONCLUSIONS
CCBs are strongly recommended for improving the prognosis of coronary spasm, but in many cases they do not suppress completely symptoms.
Ogawa
Takayuki
T
Jikei University School of Medicine, 3-25-8 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan. cj@j-circ.or.jp
Komukai
Kimiaki
K
Ogawa
Kazuo
K
Kosuga
Tsuneharu
T
Nagoshi
Tomohisa
T
Minai
Kosuke
K
Sakamoto
Hiroshi
H
Hashimoto
Koichi
K
Yoshida
Satoru
S
Taniguchi
Ikuo
I
Mochizuki
Seibu
S
Yoshimura
Michihiro
M
D000109:Acetylcholine / Q000008:administration & dosage; D000368:Aged; D000788:Angina Pectoris, Variant / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D006328:Cardiac Catheterization; D003329:Coronary Vasospasm / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D020108:Nicorandil / Q000008:administration & dosage; D009566:Nitrates / Q000008:administration & dosage; D011379:Prognosis; D011788:Quality of Life; D012008:Recurrence; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage
D002121:Calcium Channel Blockers; D009566:Nitrates; D014665:Vasodilator Agents; D020108:Nicorandil; D000109:Acetylcholine