Impact of statins in patients with vasospastic angina: A multicenter registry study of the Japanese Coronary Spasm Association

Mori, Hiromu; Takahashi, Jun; Sato, Kōichi; Miyata, Satoshi; Takagi, Yusuke; Tsunoda, Ryusuke; Sumiyoshi, Tetsuya; Matsui, Motoyuki; Tanabe, Yuji; Sueda, Shozo; Momomura, Shin‐ichi; Kaikita, Koichi; Yasuda, Satoshi; Ogawa, Hisao; Shimokawa, Hiroaki; Suzuki, Hiroshi

doi:10.1016/j.jjcc.2022.03.009

Cited by 8 publications

(8 citation statements)

References 34 publications

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“…After screening 1653 titles and abstracts, 43 studies were reviewed for detailed evaluation in full text, of which 10 adhered to our inclusion criteria and were selected for this meta-analysis [ 6 – 11 , 13 – 16 ]. The flowchart for the inclusion and exclusion process is shown in further detail in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…It is generally known that statins can reduce cardiovascular events in patients with coronary heart disease by lowering LDL cholesterol levels and protecting against coronary artery plaque formation. In our meta-analysis, some studies included patients with mild to moderate organic coronary artery stenosis; except for those without coronary artery stenosis, these patients may have reaped greater benefits of antiatherosclerotic progression from statins [ 6 – 8 , 10 , 11 ]. Additionally, experimental and clinical evidences suggest that statins improve endothelial dysfunction through antioxidation, anti-inflammation, and increased production of endothelial nitric oxide (NO) [ 24 – 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…Due to the multiple effects of statins, it is possible that statins may suppress coronary spasm and reduce adverse cardiovascular events. However, the effects of statin therapy on reducing adverse cardiovascular events in CAS have been inconsistently demonstrated in previous studies [ 6 – 11 ]. Additionally, most of the research to date has been conducted in Asia.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Statins on Major Adverse Cardiovascular Events in Patients with Coronary Artery Spasm: A Meta-Analysis of the Asia Region

Zhao

Luo

Jiang

et al. 2023

Cardiovascular Therapeutics

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Background. Whether statins can reduce major cardiovascular adverse events (MACE) in patients with coronary artery spasm (CAS) is controversial. And most of the relevant research to date has been conducted in Asia. Methods. We systematically searched electronic databases for studies on the effect of statins on MACE in patients with CAS in Asia and published up to September 2022. We included data on MACE in a statin therapy patient group and a no-statin therapy control group. We then evaluated the effect of statin therapy on MACE in patients with CAS in Asia by meta-analysis and trial sequential analysis (TSA). All statistical analyses were performed using Stata 16.0 software and TSA software. Results. A total of 10 studies ( n = 9333 patients) were included in the final analysis. Meta-analysis showed that the use of statins had a significant effect on MACE in CAS patients (with RR, 0.70; 95% CI, 0.49-0.99), and the sensitivity analysis further confirmed this finding. Subgroup analysis suggested that the correlation between statin therapy and reduced MACE endpoint was stronger in Japanese patients and patients followed up for more than 4 years. But our TSA results indicated that the available samples were insufficient and further research is needed. Conclusions. Our meta-analysis suggests that statin therapy can reduce MACE in patients with CAS in Asia, and the correlation between the two was stronger in Japanese patients and patients followed up for more than 4 years.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of Statins on Major Adverse Cardiovascular Events in Patients with Coronary Artery Spasm: A Meta-Analysis of the Asia Region

Zhao

Luo

Jiang

et al. 2023

Cardiovascular Therapeutics

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“…54 Subsequent studies focused on the effects of statins on clinical outcomes of VSA patients. [55][56][57][58][59][60][61] The main results of these studies are summarised in Table 2. Although some studies reported positive results, on the whole the available data do not suggest that statins may improve clinical outcomes in this specific population of patients and therefore they cannot be recommended as a standard therapy in VSA patients.…”

Section: Other Treatment Considerationsmentioning

confidence: 99%

Management of Coronary Artery Spasm

Lanza

Shimokawa

2023

Eur Cardiol

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Calcium channel blockers (CCBs) are the first-line treatment for coronary artery spasm (CAS). When CAS-related angina symptoms are not well controlled by CCB therapy, long-acting nitrates or (where available) nicorandil can be added as second-line medications. In the case of CAS refractory to standard treatments, several other alternative drugs and interventions have been proposed, including the Rho-kinase inhibitor fasudil, anti-adrenergic drugs, neural therapies and percutaneous coronary interventions. In patients with syncope or cardiac arrest caused by CAS-related tachyarrhythmias, or even bradyarrhythmias, implantation of an ICD or pacemaker, respectively, should be considered according to the risk of recurrence and efficacy of vasodilator therapy.

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“…Studies have shown benefits of statins in preventing CAS [ 147 ]. However, the impact of statins in reducing cardiovascular events in patients with VSA is still controversial [ 148 , 149 , 150 ].…”

Section: Managementmentioning

confidence: 99%

MINOCA: One Size Fits All? Probably Not—A Review of Etiology, Investigation, and Treatment

Oliveira

Correia²,

Nicz³

et al. 2022

JCM

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Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous group of conditions that include both atherosclerotic (coronary plaque disruption) and non-atherosclerotic (spontaneous coronary artery dissection, coronary artery spasm, coronary artery embolism, coronary microvascular dysfunction, and supply–demand mismatch) causes resulting in myocardial damage that is not due to obstructive coronary artery disease. Failure to identify the underlying cause may result in inadequate and inappropriate therapy in these patients. The cornerstone of managing MINOCA patients is to identify the underlying mechanism to achieve the target treatment. Intravascular imaging is able to identify different morphologic features of coronary plaques, while cardiac magnetic resonance is the gold standard for detection of myocardial infarction in the setting of MINOCA. In this review, we summarize the relevant clinical issues, contemporary diagnosis, and treatment options of MINOCA.

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Impact of statins in patients with vasospastic angina: A multicenter registry study of the Japanese Coronary Spasm Association

Cited by 8 publications

References 34 publications

Effect of Statins on Major Adverse Cardiovascular Events in Patients with Coronary Artery Spasm: A Meta-Analysis of the Asia Region

Effect of Statins on Major Adverse Cardiovascular Events in Patients with Coronary Artery Spasm: A Meta-Analysis of the Asia Region

Management of Coronary Artery Spasm

MINOCA: One Size Fits All? Probably Not—A Review of Etiology, Investigation, and Treatment

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