Spontaneous multi-focal coronary artery spasm: a case report

Ostovan, Mohammad Ali; Khanian, Mahdi Sajedi; Hamidi, Sahand; Fattahi, Mostafa; Dehghani, Pooyan

doi:10.15171/jcvtr.2016.28

Cited by 4 publications

(1 citation statement)

References 7 publications

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“…The authors concluded that patients with ACS who show no culprit lesion and suffer coronary spasm have an excellent and significantly better prognosis for survival and coronary events compared with patients with a culprit lesion. In a unique piece of evidence, a patient with multiple narrowings in the coronary artery angiography responded well to intracoronary nitroglycerine and was deferred from PCI [ 28 ]. In our study, out of 140 patients with STEMI, 5 (3.5%) responded to nitroglycerine and were treated medically.…”

Section: Discussionmentioning

confidence: 99%

Intracoronary injection of nitroglycerine can prevent unnecessary percutaneous coronary intervention

Nasiri-Partovi

Shafiee

Rahmani

2022

BMC Cardiovasc Disord

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Background Despite the recommendation of the current guidelines, intracoronary administration of nitroglycerine during coronary angiography is often neglected. We investigated the effect of intra-coronary nitroglycerin on the relief of coronary artery stenosis in the candidates for percutaneous coronary intervention (PCI). Methods We included patients with angina pectoris or myocardial infarction who were candidates for PCI. In the coronary angiography, the culprit vessel involved was evaluated, and bolus nitroglycerin at a dose of 25–200 mcg was injected into the affected coronary artery. A significant change in the percentage of coronary artery stenosis was considered a positive response, and these patients were then compared with patients who did not have a substantial change in the percentage of stenosis at the same time. Univariate analysis and then multivariate logistic regression analysis was performed to determine the predictors of response to intracoronary nitroglycerin. Results Among 360 patients, 27 (7.5%) responded to nitroglycerine, and 333 (92.5%) were non-responsive. The mean age of patients was 60.2 ± 11.6 years, ranging from 23 to 93 years, and 265 (73.6%) were men. The study groups were not significantly different in the baseline demographic characteristics. The presence of multivessel disease (Odds ratio (OR) = 16.26, 95% confidence interval (CI):2.07–127.6; P = 0.008) and stenosis in the left circumflex artery (OR = 3.62, 95% CI: 1.03–12.70; P = 0.044) were the independent predictors for nonresponse to nitroglycerine, leading to PCI. Conclusion In some cases, especially those without multivessel diseases, intracoronary nitroglycerine administration can efficiently relieve coronary stenosis and prevent unnecessary PCI.

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Section: Discussionmentioning

confidence: 99%