Background

There are limited data how different is clinical outcomes depending on spasm type.

Methods

A total 2812 patients (pts) undergoing coronary angiography with acetylcholine provocation test from Nov 2004 to Oct 2010 from prospective spasm registry of Cardiovascular Center of Korea University Guro Hospital were enrolled. The follow-up duration was 3-year. The patient was categorized into three groups; negative spasm test group (n=1178), others positive group (n=1098), diffuse and multivessel spasm group (n=536). The definition of diffuse spasm was defined as more than 30mm in the length of significant spasm. Others positive spasm group consisted of other positive Ach provocation test groups except diffuse and multi-vessel spasm group.

Results

In Proportional hazard Cox-regression analysis adjusted by co-variates such as age, gender, current smoking, current alcoholics, myocardial bridge, HDL cholesterol, hypertension, diabetes, and dyslipidemia, diffuse and multivessel positive spasm group had the higher incidence of recurrent chest pain requiring repeat coronary angiography during 3-year follow-up period, compared to other positive spasm group and negative spasm group. However, there was no statistic significance between other positive spasm test group and negative spasm test group (fig).

Conclusions

The diffuse and multivessel positive spasm was associated with adverse clinical outcome such as recurrent chest during 3-year follow-up period.

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