Korean Circ J.  2002 Sep;32(9):791-797. 10.4070/kcj.2002.32.9.791.

The Study of Coronary Spasm by Follow-up Coronary Angiography in Variant Angina

Affiliations
  • 1Department of Internal Medicine, College of Medicine, Chungnam National University, Daejeon, Korea.

Abstract

BACKGROUND AND OBJECTIVES: The therapeutic duration of variant angina is controversial. This study sought to determine the remission rates for coronary artery spasms, the factors associated with remission and the changes in spasm sites.
SUBJECTS AND METHODS
Fifty-eight patients were enrolled in the study. Initial, and follow-up, coronary angiographies (CAG), with ergonovine stimulation tests, were performed. Paired CAG were performed at a mean interval of 27+/-17 months. Medication was stopped 3 days prior to the follow-up CAG, and the occurrence of chest pain during these 3 days was studied. Coronary spasms were confirmed by follow-up CAG. Any changes, and the diameters, of spasm sites were analyzed on each paired CAG.
RESULTS
The remission rate of coronary spasms was 24% (14 patients), when the smoking group (49 patients) stopped smoking (31 patients), the remission rate was 29% (9 patients). In the current smoking group (18 patients), the remission rate was 6% (1 patient, p=0.05). 31 patients had chest pains after stopping medication prior to their follow-up CAG. Of those patients, 1 patient had a remission (3%). Among another 27 patients with no chest pain, 13 patients had a remission (48%, p<0.001). In 28 out of 44 patients (64%, non-remission), fluctuations in spastic locations were observed at the follow-up CAG. The interval changes in the diameter of the spasm sites were not significant.
CONCLUSION
The non-chest pain group showed higher remission rates, but lack of chest pain did not identify the loss of coronary spasm. Atherosclerosis at spasm sites did not progress, as confirmed by the paired CAG in our study.

Keyword

Angina pectoris, variant; Coronary angiography; Coronary arteriosclerosis

MeSH Terms

Angina Pectoris, Variant
Atherosclerosis
Chest Pain
Coronary Angiography*
Coronary Artery Disease
Coronary Vessels
Ergonovine
Follow-Up Studies*
Humans
Muscle Spasticity
Smoke
Smoking
Spasm*
Ergonovine
Smoke
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