Clinical and laboratory characteristics in patients with acute myocardial infarction due to occlusive vasospasm.
BACKGROUND
The purpose of this study was to determine the clinical and laboratory characteristics in patients with acute myocardial infarction (AMI) associated with coronary vasospasm.


RESULTS
Consecutive 231 patients with documented coronary vasospasm by ergonovine provocation test but with a normal-appearing coronary angiogram were divided into two groups, variant angina pectoris (VAP) patients (group I; n=202, 49.5 ± 11.1 years) and AMI patients (group II; n=29, 47.4 ± 11.2 years). Matched control patients were 84 AMI patients with significant stenosis (>50%) (group III; n=84, 61.2 ± 11.8 years). Although, the incidence of hypertension, diabetes mellitus, and smoking were lower in group I than in group III, there was no difference between group II and III (diabetes, 7.9% vs. 13.8% vs. 29.8%; hypertension, 19.8% vs. 24.1% vs. 41.7%; smoking 48% vs. 48.3% vs. 61.9%; respectively, p<0.01). Measured high-sensitivity C-reactive protein (hsCRP) and fibrinogen level were higher (respectively, p<0.001, p<0.001) in groups II and III (group II, 1.88 ± 2.9 mg/dl, 317.5 ± 51.2mg/dl; group III, 2.92 ± 3.9 mg/dl, 326.8 ± 107.7 mg/dl) than those in group I (0.68 ± 1.5mg/dl, 263.2 ± 70.3mg/dl). A correlation was clearly seen between fibrinogen and hsCRP (r=0.472, p<0.001).


CONCLUSIONS
The clinical characteristics of patients with AMI associated with spasm were similar to those with VAP, but laboratory findings were similar to those of AMI in patients with significant stenosis.
Kim
Weon
W
The Cardiology Division, Department of Internal Medicine, Kyung Hee University, Seoul, Republic of Korea.
Cho
Jung Sun
JS
Hong
Young Joon
YJ
Ahn
Youngkeun
Y
Jeong
Myung Ho
MH
D000328:Adult; D000368:Aged; D000788:Angina Pectoris, Variant; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein; D002984:Clinical Laboratory Information Systems; D023921:Coronary Stenosis; D003329:Coronary Vasospasm / Q000150:complications* / Q000175:diagnosis; D004874:Ergonovine; D005260:Female; D005340:Fibrinogen; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*
D015415:Biomarkers; D005340:Fibrinogen; D002097:C-Reactive Protein; D004874:Ergonovine