title: Comparison of long-term clinical outcomes of percutaneous coronary intervention in vasospastic angina patients associated with significant coronary artery stenosis.
abstract: BACKGROUND
  Coronary spasm is the major pathophysiology of vasospastic angina (VA). Medical treatment is usually effective in VA patients without significant stenosis. However, there is little information about the percutaneous coronary intervention (PCI) in VA patients with significant coronary artery stenosis (CAS).
  
  
  METHODS
  After retrospective screening of all consecutive VA patients from January 2010 to April 2015, we selected significant CAS (>50% of diameter stenosis) after nitrate injection and divided them into two groups according to the presence of PCI.
  
  
  RESULTS
  A total of 220 VA patients (41 females, mean age: 58±10years old) were screened, and 85 were included in this study. Males were predominant in the VA with significant CAS group (89 vs 76%, p=0.020). PCI was done in 43 patients (51%). The most common culprit coronary artery was the left anterior descending coronary artery (18, 42%), diameter stenosis was significantly higher (66±9 vs 61±10%, p<0.01), and total number of antianginal medication was significantly lower in the PCI group than in the medical group (1.7±0.9 vs 2.1±0.8, p=0.039). Moreover, 4 patients underwent PCI to control symptoms in the medical treatment group during the follow-up period (26±13months). However, additional antiplatelet therapy was necessary in patients with coronary angioplasty, and there were 2 cases with complication associated with angioplasty (1 restenosis and 1 bleeding complication).
  
  
  CONCLUSIONS
  In VA patients with significant CAS, both treatment modalities showed similar clinical outcomes. Although the PCI can afford symptomatic improvement, it needed additional antiplatelet medications and can be associated with procedural complications.
authors.affiliation: Department of Cardiology in Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Mijoo
authors.initials: M
authors.lastname: Kim
authors.affiliation: Department of Cardiology in Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea. Electronic address: jaehpark@cnu.ac.kr.
authors.forename: Jae-Hyeong
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Cardiology in Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Jae-Hwan
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Cardiology in Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Byung Joo
authors.initials: BJ
authors.lastname: Sun
authors.affiliation: Department of Cardiology in Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Seon Ah
authors.initials: SA
authors.lastname: Jin
authors.affiliation: Department of Cardiology in Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Jun Hyung
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Cardiology in Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: SiWan
authors.initials: S
authors.lastname: Choi
authors.affiliation: Department of Cardiology in Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: Jin-Ok
authors.initials: JO
authors.lastname: Jeong
authors.affiliation: Department of Cardiology in Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: In-Whan
authors.initials: IW
authors.lastname: Seong
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D017023:Coronary Angiography / Q000639:trends; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000639:trends*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Coronary artery stenosis; Coronary intervention; Percutaneous; Symptoms; Vasospastic angina