The 24-Month Prognosis of Patients With Positive or Intermediate Results in the Intracoronary Ergonovine Provocation Test

Shin, Dong Il; Baek, Sang Hong; Her, Sung Ho; Han, Seung Hwan; Ahn, Youngkeun; Park, Keun Ho; Kim, Dong Soo; Yang, Tae Hyun; Choi, Dong Ju; Suh, Jung Won; Kwon, Hyuck Moon; Lee, Byoung Kwon; Gwon, Hyeon Cheol; Rha, Seung Woon; Jo, Seong Jin

doi:10.1016/j.jcin.2014.12.249

Cited by 56 publications

(68 citation statements)

References 26 publications

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“…The incidence of VA mortality has been reported by several studies67111213141516171819202122. However, those reports were limited in size and/or duration of follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…A study of Japanese nationwide registry data of 1,244 VA patients showed that the incidence of all-cause mortality and cardiac mortality during 2.7 years of follow-up was 1.3% and 0.3%, respectively25. Korean registry data including 2,129 patients with vasospasm revealed that the 2-year incidence of cardiac death was 0.9%19. Considering our study’s considerably longer follow-up duration (median 4.9 years), the rates of cardiac mortality of the previous Korean study could be expected to be similar to ours when the follow-up duration was increased about five fold.…”

Section: Discussionmentioning

confidence: 99%

“…However, sometimes, severe coronary spasm causes acute myocardial infarction (AMI) and fatal arrhythmia such as ventricular tachycardia, ventricular fibrillation and complete atrioventricular block, and subsequent cardiac arrest and death111415. Even though some studies have investigated the outcomes and prognostic factors of patients with VA67111213141516171819202122, they had several weak points; first, sample sizes were relatively small and/or follow-up durations were short in most of those studies, therefore they would potentially have generalization problem; second. some of studies were performed several decades prior67131415, and the current VA treatment strategy using newer VA treatments such as K ATP channel agonist (nicorandil)2324, was not available for use in those studies.…”

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confidence: 99%

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Incidence and factors associated with mortality in 2,476 patients with variant angina in Korea

Kim

et al. 2017

Sci Rep

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This study investigated the incidence and risk factors of mortality in 2,476 patients with variant angina (VA) using the National Health Insurance Service–National Sample Cohort between 2004 and 2011. The risk factors of all-cause and cardiac mortality were investigated using Cox proportional hazards model. Most patients (69.5%) were less than 65 years and 42.9% were women. During the median follow-up duration of 4.9 years, there were 178 (7.2%) and 95 (3.8%) cases of all-cause and cardiac mortality, respectively. Older age, hypertension, diabetes mellitus, poor medication adherence, low household income and tertiary teaching hospitals were independent predictors for all-cause mortality, while older age, hypertension, low household income and tertiary teaching hospitals were independent predictors for cardiac mortality. In conclusion, our findings suggest that traditional risk factor control and continued medication are important to improve VA outcomes, and that household income-level factors should be considered in the assessment of risk of VA patients.

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“…The incidence of VA mortality has been reported by several studies67111213141516171819202122. However, those reports were limited in size and/or duration of follow-up.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Incidence and factors associated with mortality in 2,476 patients with variant angina in Korea

Kim

et al. 2017

Sci Rep

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“…24 Furthermore, a recent large registry study showed that patients with a positive ergonovine provocation test had low 24-month incidences of cardiac death, arrhythmia, and acute coronary syndrome (0.9%, 1.6%, and 1.9%, respectively). 36 A risk score (Japanese Coronary Spasm Association Score) has been proposed for prognostic stratification for future major adverse cardiac events and includes the following risk factors: outof-hospital cardiac arrest, tobacco use, angina only at rest, coronary artery disease, multivessel vasospasm, ST-segment elevation on ECG, and β-blocker use. 37 The incidence of major adverse cardiac events in the low-, intermediate-, and high-risk groups was 2.5%, 7.0%, and 13.0%, respectively.…”

Section: February 23 2016mentioning

confidence: 99%

A Shocking Development in a Young Male Athlete With Chest Pain

et al. 2016

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Foreword Information about a real patient is presented in stages (boldface type) to an expert clinician (Dr Deepak L. Bhatt), who responds to the information, sharing his reasoning with the reader (regular type). A discussion by the authors follows. P atient presentation:A 32-year-old male endurance athlete with no significant past history was admitted after experiencing multiple episodes of chest tightness while training for a triathlon. Occasionally, when running up hills, he noted substernal chest pressure that radiated to his left arm and was associated with severe shortness of breath. His past medical history includes seasonal allergic rhinitis and childhood asthma. He takes cetirizine/pseudoephedrine occasionally, but has not taken it recently, and denies taking any other medication or over-the-counter supplement. He admits to occasional binge drinking of 6 to 10 beers once or twice a month. He quit smoking 2 years ago but previously smoked a pack a week for 5 years. He also endorsed a remote history of cocaine use and recent marijuana and energy drink (1-2 small cans; 80 mg of caffeine per 8.4-oz can) use. His family history is only notable for a maternal grandmother who had a myocardial infarction in her 60s and a sister diagnosed with an atrial tachycardia. There is no history of premature coronary artery disease, heart failure, or sudden death. His biological parents and brother are alive and well.Dr Bhatt: At this point, the differential diagnosis for chest pain in a young, otherwise healthy patient is broad. Certainly, the exertional component of his symptoms is concerning and raises the possibility of premature coronary artery disease, although the family history obtained does not suggest a strong predisposition for atherosclerosis. Coronary artery vasospasm would be another possibility, and he has several potential triggers, including alcohol, pseudoephedrine, caffeine, and marijuana use. Vasospasm can occur with exertion, even though we often think of it as occurring at rest. Forms of structural heart disease, such as hypertrophic or infiltrative cardiomyopathy or an anomalous coronary artery, should be entertained. I would also consider an arrhythmia, either supraventricular or ventricular. The appropriate next steps are a targeted physical examination, an ECG, and a transthoracic echocardiogram to evaluate for structural heart disease. Patient presentation (continued):His vital signs were as follows: temperature, 96.0°F; blood pressure, 136/88 mm Hg; heart rate, 56 beats per minute and regular; respiratory rate, 14 breaths per minute; and oxygen saturation, 98% on room air. He was well appearing. His jugular venous pressure was 6 cm H 2 O. His lungs were clear to auscultation bilaterally. His cardiac examination revealed normal S1 and S2 heart sounds, no murmurs or gallops, no heaves, and a nondisplaced apical impulse. His extremities were warm and without edema. Serial troponin-T concentrations were undetectable. An ECG showed normal sinus rhythm with normal intervals and no evidence of hypertr...

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“…Ergonovine maleate is a weak vasoconstrictor, and induces a vasoconstrictor response in susceptible epicardial coronary arteries. This response is mediated by endothelium-independent smooth muscle hyperconstriction and more pronounced with endothelial dysfunction [7,8]. In patients with confirmed variant angina, ergonovine provocation can induce coronary artery spasm at the same site where spontaneous spasm was observed with high diagnostic sensitivity and specificity [9,10].…”

Section: Introductionmentioning

confidence: 99%

Effect of intracoronary adenosine on ergonovine-induced vasoconstricted coronary arteries

Song

Kim

et al. 2020

Cardiol J.

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The 24-Month Prognosis of Patients With Positive or Intermediate Results in the Intracoronary Ergonovine Provocation Test

Cited by 56 publications

References 26 publications

Incidence and factors associated with mortality in 2,476 patients with variant angina in Korea

Incidence and factors associated with mortality in 2,476 patients with variant angina in Korea

A Shocking Development in a Young Male Athlete With Chest Pain

Effect of intracoronary adenosine on ergonovine-induced vasoconstricted coronary arteries

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