Intermediate fixed coronary artery stenosis at the site of ergonovine-provoked spasm as a predictor of long-term major adverse cardiac events of patients with coronary spastic angina.
BACKGROUND
Organic coronary artery stenosis is a significant prognostic factor in patients with coronary spastic angina (CSA), so the present study was focused on assessing the impact of intermediate fixed stenosis at sites of provoked spasm on the long-term outcomes of CSA patients.


RESULTS
CSA patients diagnosed on the basis of ergonovine-provoked spasm were enrolled and the clinical background and long-term prognosis of CSA patients with intermediate fixed stenosis at the site of provoked spasm (with-fixed-stenosis group, n=37) and those without fixed stenosis (without-fixed-stenosis group, n=126) were retrospectively compared. During the follow-up period (average 4.01 years for with-fixed-stenosis, 4.47 years for without-fixed-stenosis), the with-fixed-stenosis group had a significantly lower event-free survival rate, as well as a higher frequency of admission for unstable angina and percutaneous coronary intervention than the without-fixed-stenosis group, whereas the survival rate did not differ significantly between the 2 groups. In the multivariate analysis, intermediate fixed stenosis at the site of provoked spasm was a predictor of long-term major adverse cardiac events (MACE).


CONCLUSIONS
Intermediate fixed stenosis at the site of ergonovine-provoked spasm is an independent risk factor for MACE during the long-term period in CSA patients.
Nishizawa
Shinya
S
Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, and Department of Cardiology, Kyoto First Red Cross Hospital, Kyoto, Japan. nshinya@koto.kpu-m.ac.jp
Shiraishi
Jun
J
Torii
Sayuki
S
Miyagawa
Kotaro
K
Arihara
Masayasu
M
Hadase
Mitsuyoshi
M
Hyogo
Masayuki
M
Yagi
Takakazu
T
Shima
Takatomo
T
Kohno
Yoshio
Y
Matsubara
Hiroaki
H
D000368:Aged; D000787:Angina Pectoris / Q000401:mortality*; D023921:Coronary Stenosis / Q000139:chemically induced / Q000401:mortality*; D003331:Coronary Vessels; D018572:Disease-Free Survival; D004874:Ergonovine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010120:Oxytocics / Q000008:administration & dosage / Q000009:adverse effects*; D012189:Retrospective Studies; D013035:Spasm / Q000139:chemically induced / Q000401:mortality*; D015996:Survival Rate
D010120:Oxytocics; D004874:Ergonovine