Impact of multi-vessel vasospastic angina on cardiovascular outcome. (February 2019)

• Record Type: Journal Article
• Authors: Han, Seung Hwan; Lee, Kwan Yong; Her, Sung Ho; Ahn, Youngkeun; Park, Keun-Ho; Kim, Dong-Soo; Yang, Tae-Hyun; Choi, Dong-Ju; Suh, Jung-Won; Kwon, Hyuck Moon; Lee, Byoung Kwon; Gwon, Hyeon-Cheol; Rha, Seung-Woon; Jo, Sang-Ho; Ko, Kwang-Pil; Baek, Sang Hong
• Is Part Of: Atherosclerosis. Volume 281(2019)
• Page Start: 107
• Page End: 113
• Publication Date: 2019-02
• Subjects: Coronary artery disease -- Vasospasm -- Multi-vessel -- Prognosis; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2018.12.018
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Background and aims: Since clinical characteristics and prognosis of patients with multi-vessel vasospastic angina (VSA) are not clear, we investigated the nature and prognosis of multi-vessel VSA in Koreans. Methods: Among 2960 patients enrolled in the VA-KOREA (Vasospastic Angina in Korea) registry, 104 definite multi-vessel VSA patients, 163 single vessel VSA patients and 737 non-VSA patients were identified using the intracoronary ergonovine provocation test. Results: Multi-vessel VSA and single vessel VSA groups showed similar baseline characteristics and medical treatment on discharge, but different from the non-VSA group. The primary composite endpoint (cardiac death, acute coronary syndrome, and symptomatic new onset arrhythmia) over a 36-month follow-up period was significantly higher in the multi-vessel VSA group than in the single vessel VSA and non-VSA groups (8.7% vs . 1.8% and 1.1%, each log-rank p < 0.05, respectively). The rate of death and acute coronary syndrome of the multi-vessel VSA group was higher than in the single vessel VSA and non-VSA groups (5.8% vs. 1.2% and 0.9%, each log-rank p < 0.05, respectively). In addition, multi-vessel VSA was an independent predictor of the primary composite endpoint at 36 months (HR 8.5, 95% CI [2.6–27.2], p < 0.0001). Conclusions: Patients with multi-vessel VSA had worse clinical outcomes than single vessel VSA and non-VSA groups, suggesting that the existence of multi-vessel VSA itself is highly prognostic. Graphical abstract: Image 1 Highlights: Prevalence of multi-vessel vasospastic angina (VSA) is not low (39.0%) by strict definition. Baseline characteristics of multi-vessel and single vessel VSA groups were similar, but different from non-VSA group. Multi-vessel VSA group had worse clinical outcomes than the single vessel and non-VSA groups. Multi-vessel VSA itself is one of the independent predictors for MACE.