title: Persistent coronary artery spasm documented by follow-up coronary angiography in patients with symptomatic remission of variant angina.
abstract: For patients with variant angina it is very important to start medical therapy using calcium-channel blockers. However, the decision of physicians regarding whether to decrease the dose of the drug or discontinue it is controversial. We investigated whether the nature of spasm is remissive and whether the termination of medications is safe. The subjects studied were included in the Vasospastic Angina in Catholic Medical Center Registry from March 2001 to December 2009. We analyzed 37 patients (62 lesions) with variant angina, diagnosed using coronary angiography (CAG) and he acetylcholine provocation test, without any organic coronary stenosis, whose symptoms were well controlled after medication. The follow-up CAG with provocation test was performed at a median interval of 44 months. The characteristics of spasm were analyzed on each pair of CAGs. The study group consisted of 23 men (62.2 %) and 14 women (37.8 %) with a mean age of 59 ± 11.1 years. The follow-up CAG with provocation test showed that the characteristics of the spasmodic nature were consistent with the first test in all patients. Although the patients with variant angina had no chest pain after medical treatment, the spasmodic nature of coronary arteries still remained. We may decrease the drug dosage after carefully checking the patient's symptoms but recommend not discontinuing therapy, even if the patient is asymptomatic.
authors.affiliation: Cardiovascular Center and Cardiology Division, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.
authors.forename: Suk Min
authors.initials: SM
authors.lastname: Seo
authors.forename: Pum Joon
authors.initials: PJ
authors.lastname: Kim
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Shin
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Kim
authors.forename: Chan Jun
authors.initials: CJ
authors.lastname: Kim
authors.forename: Jin-soo
authors.initials: JS
authors.lastname: Min
authors.forename: Yoon Seok
authors.initials: YS
authors.lastname: Koh
authors.forename: Hun Jun
authors.initials: HJ
authors.lastname: Park
authors.forename: Dong Bin
authors.initials: DB
authors.lastname: Kim
authors.forename: Sung-Ho
authors.initials: SH
authors.lastname: Her
authors.forename: Ki-Yuk
authors.initials: KY
authors.lastname: Chang
authors.forename: Sang Hong
authors.initials: SH
authors.lastname: Baek
authors.forename: Wook Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Ki-Bae
authors.initials: KB
authors.lastname: Seung
mesh_terms: D000109:Acetylcholine; D000368:Aged; D000788:Angina Pectoris, Variant / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002121:Calcium Channel Blockers / Q000008:administration & dosage; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging* / Q000188:drug therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000187:drug effects; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012042:Registries; D012074:Remission Induction; D056910:Republic of Korea; D013997:Time Factors; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D002121:Calcium Channel Blockers; D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents; D000109:Acetylcholine