Five-year clinical outcomes in patients with significant coronary artery spasm: a propensity score-matched analysis

Coronary artery spasm (CAS) is known to be a risk factor of acute coronary syndrome and angina pectoris. However, there is no currently available data with larger study population regarding long-term clinical outcomes of CAS in real world clinical practice. We evaluated the prevalence of CAS and th...

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Main Authors:	Byoung, Geol Choi, Park, Sang-Ho, Seung, Woon Rha, Ji, Young Park, Se, Yeon Choi, Yoonjee, Park, Shaopeng , Xu, Ngow, Harris Abdullah, Ali, Jabar, Hu, Li, Ji, Bak Kim, Sunki, Lee, Jin, Oh Na, Cheol, Ung Choi, Hong, Euy Lim, Jin, Won Kim, Eung, Ju Kim, Chang, Gyu Park, Hong, Seog Seo, Dong, Joo Oh
Format:	Article
Language:	English
Published:	Elsevier Ireland Ltd 2015
Subjects:	RC Internal medicine
Online Access:	http://irep.iium.edu.my/42699/ http://irep.iium.edu.my/42699/ http://irep.iium.edu.my/42699/ http://irep.iium.edu.my/42699/1/Five-year_clinical_outcomes_in_patients_with_significant_coronary_artery_spasm.pdf

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spelling	iium-426992015-04-20T02:15:12Z http://irep.iium.edu.my/42699/ Five-year clinical outcomes in patients with significant coronary artery spasm: a propensity score-matched analysis Byoung, Geol Choi Park, Sang-Ho Seung, Woon Rha Ji, Young Park Se, Yeon Choi Yoonjee, Park Shaopeng , Xu Ngow, Harris Abdullah Ali, Jabar Hu, Li Ji, Bak Kim Sunki, Lee Jin, Oh Na Cheol, Ung Choi Hong, Euy Lim Jin, Won Kim Eung, Ju Kim Chang, Gyu Park Hong, Seog Seo Dong, Joo Oh RC Internal medicine Coronary artery spasm (CAS) is known to be a risk factor of acute coronary syndrome and angina pectoris. However, there is no currently available data with larger study population regarding long-term clinical outcomes of CAS in real world clinical practice. We evaluated the prevalence of CAS and the impact of CAS on 5-year clinical outcomes in a series of Asian CAS patients documented by intracoronary acetylcholine (Ach) provocation test. A total of 1413 consecutive patients without significant coronary artery disease (CAD) who underwent Ach provocation test between Nov. 2004 and Oct. 2008 were enrolled. Significant CAS was defined as > 70% of narrowing by incremental intracoronary injection of 20, 50 and 100 μg. Patients were divided into two groups based on the presence of significant CAS (the non-CAS group: n = 640, the CAS group; n = 773). To adjust potential confounders, a propensity score matched (PSM) analysis was performed using the logistic regression model. A total of 54.7% (773/1413) patients were diagnosed as CAS documented by Ach provocation test. After PSM analysis, 2 propensity-matched groups (451 pairs, n = 902, C-statistic = 0.677) were generated. Despite of similar incidence of individual hard endpoints including mortality, myocardial infarction and revascularization, the CAS group showed the higher trend of recurrent angina requiring follow up angiography than the non-CAS group up to 5 years (HR; 1.56, 95% C.I.; 0.99–2.46, p = 0.054). The prevalence of CAS was 54.7%. Although the cumulative incidence of recurrent angina requiring follow up coronary angiography seems to be increased up to 5 years in CAS patients, CAS patients was not associated with major individual and composite clinical outcomes such as mortality, MI, PCI, CVA with optimal medical therapy as compared with patients without CAS. Elsevier Ireland Ltd 2015 Article PeerReviewed application/pdf en http://irep.iium.edu.my/42699/1/Five-year_clinical_outcomes_in_patients_with_significant_coronary_artery_spasm.pdf Byoung, Geol Choi and Park, Sang-Ho and Seung, Woon Rha and Ji, Young Park and Se, Yeon Choi and Yoonjee, Park and Shaopeng , Xu and Ngow, Harris Abdullah and Ali, Jabar and Hu, Li and Ji, Bak Kim and Sunki, Lee and Jin, Oh Na and Cheol, Ung Choi and Hong, Euy Lim and Jin, Won Kim and Eung, Ju Kim and Chang, Gyu Park and Hong, Seog Seo and Dong, Joo Oh (2015) Five-year clinical outcomes in patients with significant coronary artery spasm: a propensity score-matched analysis. International Journal of Cardiology, 184. pp. 533-539. ISSN 0167-5273 http://www.sciencedirect.com/science/article/pii/S0167527315001485 10.1016/j.ijcard.2015.02.021
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	RC Internal medicine
spellingShingle	RC Internal medicine Byoung, Geol Choi Park, Sang-Ho Seung, Woon Rha Ji, Young Park Se, Yeon Choi Yoonjee, Park Shaopeng , Xu Ngow, Harris Abdullah Ali, Jabar Hu, Li Ji, Bak Kim Sunki, Lee Jin, Oh Na Cheol, Ung Choi Hong, Euy Lim Jin, Won Kim Eung, Ju Kim Chang, Gyu Park Hong, Seog Seo Dong, Joo Oh Five-year clinical outcomes in patients with significant coronary artery spasm: a propensity score-matched analysis
description	Coronary artery spasm (CAS) is known to be a risk factor of acute coronary syndrome and angina pectoris. However, there is no currently available data with larger study population regarding long-term clinical outcomes of CAS in real world clinical practice. We evaluated the prevalence of CAS and the impact of CAS on 5-year clinical outcomes in a series of Asian CAS patients documented by intracoronary acetylcholine (Ach) provocation test. A total of 1413 consecutive patients without significant coronary artery disease (CAD) who underwent Ach provocation test between Nov. 2004 and Oct. 2008 were enrolled. Significant CAS was defined as > 70% of narrowing by incremental intracoronary injection of 20, 50 and 100 μg. Patients were divided into two groups based on the presence of significant CAS (the non-CAS group: n = 640, the CAS group; n = 773). To adjust potential confounders, a propensity score matched (PSM) analysis was performed using the logistic regression model. A total of 54.7% (773/1413) patients were diagnosed as CAS documented by Ach provocation test. After PSM analysis, 2 propensity-matched groups (451 pairs, n = 902, C-statistic = 0.677) were generated. Despite of similar incidence of individual hard endpoints including mortality, myocardial infarction and revascularization, the CAS group showed the higher trend of recurrent angina requiring follow up angiography than the non-CAS group up to 5 years (HR; 1.56, 95% C.I.; 0.99–2.46, p = 0.054). The prevalence of CAS was 54.7%. Although the cumulative incidence of recurrent angina requiring follow up coronary angiography seems to be increased up to 5 years in CAS patients, CAS patients was not associated with major individual and composite clinical outcomes such as mortality, MI, PCI, CVA with optimal medical therapy as compared with patients without CAS.
format	Article
author	Byoung, Geol Choi Park, Sang-Ho Seung, Woon Rha Ji, Young Park Se, Yeon Choi Yoonjee, Park Shaopeng , Xu Ngow, Harris Abdullah Ali, Jabar Hu, Li Ji, Bak Kim Sunki, Lee Jin, Oh Na Cheol, Ung Choi Hong, Euy Lim Jin, Won Kim Eung, Ju Kim Chang, Gyu Park Hong, Seog Seo Dong, Joo Oh
author_facet	Byoung, Geol Choi Park, Sang-Ho Seung, Woon Rha Ji, Young Park Se, Yeon Choi Yoonjee, Park Shaopeng , Xu Ngow, Harris Abdullah Ali, Jabar Hu, Li Ji, Bak Kim Sunki, Lee Jin, Oh Na Cheol, Ung Choi Hong, Euy Lim Jin, Won Kim Eung, Ju Kim Chang, Gyu Park Hong, Seog Seo Dong, Joo Oh
author_sort	Byoung, Geol Choi
title	Five-year clinical outcomes in patients with significant coronary artery spasm: a propensity score-matched analysis
title_short	Five-year clinical outcomes in patients with significant coronary artery spasm: a propensity score-matched analysis
title_full	Five-year clinical outcomes in patients with significant coronary artery spasm: a propensity score-matched analysis
title_fullStr	Five-year clinical outcomes in patients with significant coronary artery spasm: a propensity score-matched analysis
title_full_unstemmed	Five-year clinical outcomes in patients with significant coronary artery spasm: a propensity score-matched analysis
title_sort	five-year clinical outcomes in patients with significant coronary artery spasm: a propensity score-matched analysis
publisher	Elsevier Ireland Ltd
publishDate	2015
url	http://irep.iium.edu.my/42699/ http://irep.iium.edu.my/42699/ http://irep.iium.edu.my/42699/ http://irep.iium.edu.my/42699/1/Five-year_clinical_outcomes_in_patients_with_significant_coronary_artery_spasm.pdf
first_indexed	2023-09-18T21:00:50Z
last_indexed	2023-09-18T21:00:50Z
_version_	1777410612493549568

Five-year clinical outcomes in patients with significant coronary artery spasm: a propensity score-matched analysis

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