Coronary Artery Spasm: Risk Factors, Pathophysiological Mechanisms and Novel Diagnostic Approaches

Abstract

Coronary artery spasm (CAS) is a transient reversible subtotal or complete occlusion induced by coronary hypercontraction and the critical cause of myocardial ischaemia with non-obstructive coronary arteries. During the past decades, our knowledge of the risk factors and pathophysiological mechanisms of CAS have been increasingly progressed, and various diagnostic approaches, including imaging technologies and novel biomarkers, have been proposed to serve well to diagnose CAS clinically. This review aims to summarize these research progresses on the risk factors of CAS and introduce current knowledge about the mechanisms accounting for CAS, including endothelial dysfunction, vascular smooth muscle cell hyperreactivity, and adventitial and perivascular adipose tissue inflammation. We also gathered the recently evolved diagnostic approaches and analyzed their advantages/disadvantages, in purpose of enhancing the diagnostic yield on the basis of ensuring accuracy.

Phosphorylated CPI-17 and MLC2 as Biomarkers of Coronary Artery Spasm–Induced Sudden Cardiac Death

“…CAS can significantly affect patient quality of life and prognosis, placing a huge economic burden on health services [ 26 , 27 ]. In forensic practice, CAS is highly suspected as the cause of death in many sudden-death cases if there are significant predisposing factors (e.g., disputes with other people, overexertion, cold stimulus) [ 28 ]. However, such cases lack specific diagnostic biomarkers; therefore, the identification opinions are controversial, resulting in adverse social effects.…”

Frequency and Clinical Impact of Family History of Coronary Artery Disease in Patients with Vasospastic Angina

“…Vasospastic angina (VSA) is a disease in which epicardial coronary arteries constrict, resulting in myocardial ischemia that induces resting angina pectoris or exertional angina, acute coronary syndrome, heart failure and sudden death [ 1 , 2 , 3 , 4 , 5 , 6 ]. Recently, more emphasis has been placed on the aetiology, diagnosis and treatment of VSA as a cause of ischemia and myocardial infarction with nonobstructive coronary artery disease (CAD).…”