Factors influencing the clinical course and the long-term prognosis of patients with variant angina.

Kuroda, Hiroshi; Hata, Noritake; Kusama, Yoshiki; Suzuki, Takeshi; Saito, Tsutomu; Nejima, Jun; Otsu, Fumio; Yasutake, Masahiro; Koumi, Shin-ichi; Nakagomi, Akihiro

doi:10.1536/ihj.28.293

Cited by 5 publications

(2 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, none of these studies examined the prognostic impact of CVS. Generally, the prognosis for patients with CVS is good, with less than 5% of cases developing acute MI (AMI) [13]. Nonetheless, CVS can also cause sudden death [14].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Prognosis of Patients with Myocardial Infarction Type 1 and Type 2 with and without Involvement of Coronary Vasospasm

Sato

Sakamoto

Kaikita

et al. 2020

JCM

View full text Add to dashboard Cite

While prognoses in relation to myocardial infarction (MI) type have been elucidated in past reports, the results were not consistent, perhaps due to occurrence of Type 2 MI with CVS and its mortality. The Japanese registry of acute Myocardial Infarction diagnosed by Universal Definition (J-MINUET) is a prospective multicenter registry in Japan. In contrast to thromboembolic event-related Type 1 myocardial infarction (MI), clinical features of Type 2 MI, including coronary vasospasm (CVS), are varied due to the heterogeneous nature of its development. To elucidate the MI type-related all-cause mortality, 2989 consecutive patients with AMI were stratified as Type 1 MI, Type 2 MI with CVS, and Type 2 MI with non-CVS. Most patients (n = 2834; 94.8%) were classified as Type 1 MI and 155 patients (5.2%) were classified as Type 2 MI. Of the Type 2 MI patients, 87 (56% of Type 2 MI) were diagnosed as MI with CVS. Although the 3-year mortality was comparable between Type 1 and Type 2 MI patients, significant differences were observed between Type 2 MI with CVS and with non-CVS (3.4% and 22.1%, p < 0.001). Among Japanese patients with AMI, mortality rates between Type 1 MI and Type 2 MI are comparable, but further stratification of Type 2 MI (with or without CVS) may be useful in predicting the prognosis of patients with Type 2 MI.

show abstract

Section: Introductionmentioning

confidence: 99%

Long-Term Prognosis of Patients with Myocardial Infarction Type 1 and Type 2 with and without Involvement of Coronary Vasospasm

Sato

Sakamoto

Kaikita

et al. 2020

JCM

View full text Add to dashboard Cite

show abstract

“…Each spasm is a reversible stenosis that limits coronary blood flow under resting conditions, occasionally causing myocardial infarction or stunning in cases of severe and prolonged ischemia. 8,9) Because both myocardial infarction and stunning show similar chest symptoms, elevated cardiac markers, ECG findings, and LV wall abnormalities, cardiac MRI and SPECT are used to differentiate between the 2 conditions in our hospital.…”

Section: Discussionmentioning

confidence: 99%

Coronary Spastic Angina Causing Myocardial Stunning Associated with Reversible Wall Thinning and Motion Abnormality of the Left Ventricle: A Case Report

et al. 2013

View full text Add to dashboard Cite

A 70-year-old woman presented to our emergency department with sudden resting angina at 8 p.m. Although she had experienced similar episodes over the previous 2 years, she had not previously sought medical attention, as these episodes had not been severe. She was a non-smoker with a prior history of untreated hypertension. On admission, her blood pressure was high (systolic/diastolic blood pressure, 173/109 mmHg), but findings of physical examination were otherwise unremarkable. A 12-lead electrocardiogram (ECG) showed ST-segment elevation in leads I, aVL, and V2-V6 and reciprocal ST-segment depression in leads II, III, and aVF (Fig. 1A). The symptoms were resolved with an intravenous injection of isosorbide dinitrate. To investigate the myocardial damage in detail, we performed cardiac magnetic resonance imaging (MRI) on hospitalization day 2. Although cardiac MRI showed anterior wall thinning, late gadolinium enhancement (LGE) was not detected (Fig. 4). We also examined the cardiac single photon emission computed tomography (SPECT) using 123 iodine beta methyl-iodophenyl pentadecanoic acid ( 123 I-BMIPP) and 201 thallium ( 201 Tl) on hospitalization day 5. The dual cardiac SPECT revealed a mismatch from the apex to the mid-anterior LV; 123 I-BMIPP images showed that the defect was ischemic memory (Fig. 5). Thus, cardiac MRI and SPECT were able to differentiate between infarcted and stunned myocardium. Coronary Spastic Angina Causing Myocardial Stunning Associated with Reversible Wall Thinning and Motion Abnormality of the Left Ventricle: a Case ReportToshiaki Isogai, Hiroyuki Tanaka, Motohiro Asaki, Tetsuro Ueda We describe a rare case of coronary spastic angina (CSA) causing myocardial stunning with reversible wall thinning and motion abnormality of the left ventricle (LV). A 70-year-old woman presented with sudden resting angina. A 12-lead electrocardiogram showed typical ST-T changes of acute myocardial infarction. Although left ventriculography revealed akinesis from the apex to the mid-anterior LV, urgent coronary angiography did not show an obstructed coronary artery. Cardiac magnetic resonance imaging (MRI) identified thinning of the anterior wall in the akinetic region, without any late gadolinium enhancement. Cardiac single photon emission computed tomography (SPECT), using 123 iodine beta methyl-iodophenyl pentadecanoic acid ( 123 I-BMIPP) and 201 thallium ( 201 Tl), showed a mismatch congruent with the akinetic region. An acetylcholine provocation test performed during hospitalization revealed multivessel coronary spasms in all 3 epicardial arteries. After initiation of treatment with coronary vasodilators, the wall thinning and motion abnormality gradually recovered to the normal range. In the present case, CSA caused myocardial stunning associated with reversible wall thinning and motion abnormality in the acute phase. CSA can occasionally lead to two conditions associated with LV wall abnormalities: myocardial infarction and stunning. Although the findings of the 2 conditions are similar in the a...

show abstract

Wat is Prinzmetal angina pectoris, hoe is de behandeling en de prognose?

Brouwer¹,

Verheugt²

2006

Vademecum Permanente Nascholing Huisartsen

View full text Add to dashboard Cite

Factors influencing the clinical course and the long-term prognosis of patients with variant angina.

Cited by 5 publications

References 28 publications

Long-Term Prognosis of Patients with Myocardial Infarction Type 1 and Type 2 with and without Involvement of Coronary Vasospasm

Long-Term Prognosis of Patients with Myocardial Infarction Type 1 and Type 2 with and without Involvement of Coronary Vasospasm

Coronary Spastic Angina Causing Myocardial Stunning Associated with Reversible Wall Thinning and Motion Abnormality of the Left Ventricle: A Case Report

Wat is Prinzmetal angina pectoris, hoe is de behandeling en de prognose?

Contact Info

Product

Resources

About