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Persistent coronary artery spasm documented by follow-up coronary angiography in patients with symptomatic remission of variant angina

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Abstract

For patients with variant angina it is very important to start medical therapy using calcium-channel blockers. However, the decision of physicians regarding whether to decrease the dose of the drug or discontinue it is controversial. We investigated whether the nature of spasm is remissive and whether the termination of medications is safe. The subjects studied were included in the Vasospastic Angina in Catholic Medical Center Registry from March 2001 to December 2009. We analyzed 37 patients (62 lesions) with variant angina, diagnosed using coronary angiography (CAG) and he acetylcholine provocation test, without any organic coronary stenosis, whose symptoms were well controlled after medication. The follow-up CAG with provocation test was performed at a median interval of 44 months. The characteristics of spasm were analyzed on each pair of CAGs. The study group consisted of 23 men (62.2 %) and 14 women (37.8 %) with a mean age of 59 ± 11.1 years. The follow-up CAG with provocation test showed that the characteristics of the spasmodic nature were consistent with the first test in all patients. Although the patients with variant angina had no chest pain after medical treatment, the spasmodic nature of coronary arteries still remained. We may decrease the drug dosage after carefully checking the patient’s symptoms but recommend not discontinuing therapy, even if the patient is asymptomatic.

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Authors and Affiliations

  1. Cardiovascular Center and Cardiology Division, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, Korea

    Suk Min Seo & Dong Il Shin

  2. Cardiovascular Center and Cardiology Division, Seoul St. Mary’s Hospital, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Ku, Seoul, 137-040, Korea

    Pum Joon Kim, Tae-Hoon Kim, Chan Jun Kim, Jin-soo Min, Hun Jun Park, Ki-Yuk Chang, Sang Hong Baek, Wook Sung Chung & Ki-Bae Seung

  3. Cardiovascular Center and Cardiology Division, Uijeongbu St. Mary’s Hospital, The Catholic University of Korea, Uijeongbu, Korea

    Yoon Seok Koh

  4. Cardiovascular Center and Cardiology Division, St. Paul’s Hospital, The Catholic University of Korea, Seoul, Korea

    Dong Bin Kim

  5. Cardiovascular Center and Cardiology Division, Daejeon St. Mary’s Hospital, The Catholic University of Korea, Daejeon, Korea

    Sung-Ho Her

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  1. Suk Min Seo
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  2. Pum Joon Kim
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Correspondence to Pum Joon Kim.

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Seo, S.M., Kim, P.J., Shin, D.I. et al. Persistent coronary artery spasm documented by follow-up coronary angiography in patients with symptomatic remission of variant angina. Heart Vessels 28, 301–307 (2013). https://doi.org/10.1007/s00380-012-0249-2

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