title: Diffuse multi-vessel coronary artery spasm: incidence and clinical prognosis.
abstract: BACKGROUND
  The incidence and clinical prognosis of diffuse and multivessel coronary spasm has not been reported.
  
  
  METHODS
  Patients with suspected vasospastic angina were prospectively enrolled. Left and right coronary angiogram was performed simultaneously after intravenous ergonovine injection. Spasm (>70% luminal narrowing) was sub-classified as diffuse (more than 20mm length), multivessel (more than 2 epicardial arteries). Clinical characteristics and prognosis were analyzed.
  
  
  RESULTS
  Patients (96 consecutive patients, 56 males, mean age 48 years) were divided into 3 groups: diffuse-multivessel spasm (group I, n=16, 16.7%), other types of spasm (group II, n=12, 12.5%) and control group (group III, n=68, 70.8%). The rates of males, alcohol drinkers and the mean triglyceride were higher, and high density lipoprotein was lower in group I compared to group III (all p<0.05), but similar to group II (all p=NS). Hard cardiovascular event rates did not differ among groups (one cardiac arrest but successful resuscitation in group I, one non-fatal myocardial infarction in group III) during follow up periods (mean, 41.2 ± 13.7 months). Chest pain free survivals during 1 year were lower in group I (66.7%) compared to group III (90%), but similar to group II (58.3%) (group I vs III, p<0.05 and group I vs II, p=NS).
  
  
  CONCLUSIONS
  Diffuse-multivessel spasm was not rare in patients with vasospastic angina and its prognosis is pretty good similar to patients with previously known variant angina with recommended medical treatment.
authors.affiliation: Department of Cardiology, Gil Hospital, Gachon University of Medicine and Science, Incheon, South Korea.
authors.forename: Yae Min
authors.initials: YM
authors.lastname: Park
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Han
authors.forename: Kwang-Pil
authors.initials: KP
authors.lastname: Ko
authors.forename: Kwang Kon
authors.initials: KK
authors.lastname: Koh
authors.forename: Woong Chol
authors.initials: WC
authors.lastname: Kang
authors.forename: Kyounghoon
authors.initials: K
authors.lastname: Lee
authors.forename: Kwen-Chul
authors.initials: KC
authors.lastname: Shin
authors.forename: Soon Yong
authors.initials: SY
authors.lastname: Suh
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Ahn
authors.forename: In Suk
authors.initials: IS
authors.lastname: Choi
authors.forename: Eak Kyun
authors.initials: EK
authors.lastname: Shin
mesh_terms: D000328:Adult; D017023:Coronary Angiography / Q000379:methods; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies