Long-Term Prognosis and Clinical Characteristics of Patients With Variant Angina.
10.4070/kcj.2008.38.12.651
- Author:
Sang Yong YOO
1
;
Dae Hee SHIN
;
Jeong Ihm JEONG
;
Juneyoung YOON
;
Dong Cheon HA
;
Sung Won CHO
;
Sang Sig CHEONG
Author Information
1. Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, Korea. sscheong@gnah.co.kr
- Publication Type:Original Article
- Keywords:
Angina pectoris, variant;
Prognosis
- MeSH:
Angina Pectoris, Variant;
Calcium Channel Blockers;
Coronary Angiography;
Death;
Death, Sudden, Cardiac;
Ergonovine;
Heart Arrest;
Hospitalization;
Humans;
Lost to Follow-Up;
Male;
Myocardial Infarction;
Prognosis;
Resuscitation;
Risk Factors;
Smoke;
Smoking;
Spasm
- From:Korean Circulation Journal
2008;38(12):651-658
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: The overall prognosis of patients with vasospastic angina (VA) is relatively good. However, the long-term prognosis and its influencing factors are not well understood in Korean patients. SUBJECTS AND METHODS: Between August 1996 and January 2007, 256 consecutive patients with VA were reviewed (215 men, 53+/-9 years). Coronary spasm was confirmed via intravenous ergonovine provocation in all study patients during coronary angiography. Major adverse cardiac events (MACEs) were defined as myocardial infarction (MI), resuscitation from cardiac arrest, or repeat hospitalization due to recurrent angina. RESULTS: The 256 patients were followed for an average of 59 months (range, 5 months to 11 years). Thirty-one patients (12.1%) were lost to follow-up. Cardiac deaths occurred in 6 patients (2.3%), non-fatal MIs occurred in 3 patients (1.2%), and MACEs occurred in 52 patients (20.3%). The rates of survival at 1, 3, and 5 years were 99%, 97%, and 97%, respectively, and the rates of MI-free survival at 1, 3, and 5 years were 99%, 96%, and 95%, respectively. Rates of MACE-free survival at 1, 3, and 5 years were 91%, 81%, and 62%, respectively. MI at initial presentation and current smoking were factors significantly associated with MACEs; these factors were also independent predictors of MACE-free survival. CONCLUSION: Despite treatment with calcium channel blockers, recurrent episodes of angina were frequently observed, whereas sudden cardiac death and non-fatal MI were rare. Smoking and myocardial infarction at admission were independent risk factors for cardiac death, non-fatal MI, and repeat hospitalization due to recurrent angina in patients with variant angina.
