Background

It has been not known how baseline coronary spasm have an effect on long-term clinical outcome such as recurrent chest pain in patients with positive coronary artery spasm.

Methods

The baseline coronary spasm was defined that the diameter of epicardial coronary artery after nitroglycerin administration increase more than 30%, compared to baseline. Also, positive coronary artery spasm was defined as coronary vasospasm of more than 70%, compared to baseline. Patients were excluded as follows; history of acute coronary syndrome, coronary artery bypass graft, percutaneous coronary intervention, and advanced heart failure. The duration of follow-up was 3-year. A total of 1,546 patients were finally enrolled (baseline spasm, n=402; control, n=1144).

Results

Baseline clinical characteristics such as gender, hypertension, diabetes, dyslipidemia, current smoking, myocardial bridge was balanced between two groups except current alcoholics. In multivariate binary logistic regression analysis adjusted by co-variates, baseline spasm was associated with the increased incidence of recurrent chest pain (OR, 1.791; 95% CI, 1.103-2.907). Also, In Kaplan-Meyer curve, the incidence of recurrent chest pain requiring repeat coronary angiograpraphy was lower in the baseline spasm group than the control group (log rank test, p=0.017) (fig).

Conclusions

In our study, we found that baseline spasm increased the incidence of recurrent chest pain during 3-year follow-up period.

Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.