title: First report of the successful use of bosentan in refractory vasospastic angina.
abstract: Variant angina is caused by focal spasm of the epicardial coronary arteries and is variably associated with atherosclerotic coronary disease. We present the clinical course of profound coronary spasm in a woman which resulted in life-threatening symptoms. Although not previously reported, administration of the endothelin antagonist bosentan resulted in complete resolution of her symptoms which were refractory to commonly used anti-anginals, and these symptoms recurred when the drug was inadvertently withdrawn, confirming efficacy of the agent. The details of her clinical outcome and a review of the role of endothelin and its antagonists in coronary vasospasm are discussed.
authors.affiliation: Department of Cardiology, Royal Liverpool University Hospital, Liverpool, UK. unni.krishnan@nhs.net
authors.forename: Unni
authors.initials: U
authors.lastname: Krishnan
authors.forename: Wutyee
authors.initials: W
authors.lastname: Win
authors.forename: Michael
authors.initials: M
authors.lastname: Fisher
mesh_terms: D000788:Angina Pectoris, Variant / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000077300:Bosentan; D003329:Coronary Vasospasm / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D016232:Endothelins / Q000037:antagonists & inhibitors* / Q000378:metabolism; D005260:Female; D006801:Humans; D008875:Middle Aged; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D016232:Endothelins; D013449:Sulfonamides; D000077300:Bosentan