Published online Sep 26, 2020. doi: 10.4330/wjc.v12.i9.450
Peer-review started: June 28, 2020
First decision: June 15, 2020
Revised: June 28, 2020
Accepted: September 15, 2020
Article in press: September 15, 2020
Published online: September 26, 2020
Patients with vasospastic angina (VSA) sometimes experience prolonged chest symptoms. The clinical characteristics of these patients have not been clarified.
To investigate the clinical characteristics of prolonged VSA patients.
This study included 167 patients with VSA diagnosed by spasm provocation tests (SPTs) using acetylcholine, which recorded the frequencies of positive reactions to a low dose of acetylcholine (L-ACh), total occlusion due to spasm (TOC), focal spasm, and the unavoidable use of nitroglycerin (unavoidable-NTG) during SPTs. The patients underwent a medical interview that investigated the maximum duration and frequency of chest symptoms as well as the frequencies of variant angina and other serious symptoms. The patients were divided into two groups based on the maximal duration: The short-duration group (< 15 min; n = 114) and the long-duration group (≥ 15 min; n = 53). They were also divided into two groups based on the frequency of chest symptoms: The low-frequency group (< 4/mo; n = 88) and the high-frequency group (≥ 4/mo; n = 79).
The long-duration group showed higher frequencies of other serious symptoms (P < 0.001) and variant angina (P < 0.05) as well as higher frequencies of spasm induction by L-ACh (P < 0.05), TOC (P < 0.05), focal spasm (P < 0.01), and unavoidable-NTG (P < 0.01) than the short-duration group. These parameters did not differ significantly between the low-frequency and high-frequency groups.
These findings suggest that patients with VSA who experience prolonged chest symptoms may have more severe characteristics of VSA.
Core Tip: We have sometimes experienced patients with vasospastic angina (VSA) who had prolonged chest symptoms (≥ 15 min). We showed that such VSA patients had higher frequencies of other serious symptoms and variant angina as well as higher frequencies of spasm induction by a low dose of acetylcholine, total occlusion due to spasm, focal spasm, and unavoidable use of nitroglycerin in the spasm provocation test (SPT). On the other hand, the frequency of chest symptoms did not influence these findings in the SPT. Prolonged chest symptoms may be related to more severe characteristics of VSA.