title: Long-term clinical course of patients with isolated myocardial bridge.
abstract: BACKGROUND
  Myocardial bridge (MB) is regarded as a common benign lesion on coronary angiography (CAG). It is known to be harmless but may cause several cardiac events and recurrent hospitalization, so in the present study the long-term clinical course of patients with isolated MB and predictors of readmission were investigated.
  
  
  RESULTS
  Total 684 patients (343 males, 60.5+/-11.2 years) with persistent chest pain without critical stenosis on CAG were enrolled. The patients were divided into 2 groups according to the presence of MB. Clinical follow-up was performed with respect to readmission after baseline CAG. At a mean follow-up of 37 months, 92 patients (13.3%) were re-admitted because of 79 recurrent chest pain refractory to medication (11.5%), 8 myocardial infarctions (1.2%), 1 life-threatening arrhythmia (0.1%) and 4 deaths (0.6%). There was a significant higher incidence of readmission in the MB group (P=0.038). In multivariate analysis, long MB (hazard ratio (HR) 2.780; 95% confidence interval (CI) 1.070-7.218, P=0.036) and spontaneous vasospasm in CAG (HR 2.335; 95%CI 1.055-5.171, P=0.037) were the predictors of readmission. Moreover, additional use of aspirin or statin decreased the readmission rate.
  
  
  CONCLUSIONS
  This study suggests that MB on non-occlusive CAG is not benign and may cause recurrent chest pain, myocardial infarction or life-threatening arrhythmia. Especially, patients with a long MB and vasospasm on CAG need intensive medical therapy, including antiplatelet treatment.
authors.affiliation: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Kim
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Hyun Kuk
authors.initials: HK
authors.lastname: Kim
authors.forename: Min Chul
authors.initials: MC
authors.lastname: Kim
authors.forename: Kyung Hun
authors.initials: KH
authors.lastname: Cho
authors.forename: Min Goo
authors.initials: MG
authors.lastname: Lee
authors.forename: Jum Suk
authors.initials: JS
authors.lastname: Ko
authors.forename: Keun Ho
authors.initials: KH
authors.lastname: Park
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.forename: Nam Sik
authors.initials: NS
authors.lastname: Yoon
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Yoon
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Young Keun
authors.initials: YK
authors.lastname: Ahn
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology; D001241:Aspirin / Q000627:therapeutic use; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D054084:Myocardial Bridging / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology*; D009203:Myocardial Infarction / Q000453:epidemiology*; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin