Clinical impact of statin therapy on vasospastic angina: data from a Korea nation-wide cohort study

Seo, Won‐Woo; Jo, Sang‐Ho; Kim, Sung Eun; Han, Seung Hwan; Lee, Kwan Yong; Her, Sung Ho; Cho, Sung Seek; Baek, Sang Hong

doi:10.1007/s00380-020-01579-z

Cited by 14 publications

(8 citation statements)

References 31 publications

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“…Consistent with this finding, Kim et al showed that patients with a focal spasm induced by ergonovine had a significantly higher 2-year incidence of cardiac events, including cardiac death, ACS, and arrhythmia, than in those with a diffuse spasm [ 55 ]. Similar findings were also found in other studies [ 56 , 57 ]. It has been reported that long-term prognosis was worse in VSA patients with a coronary spasm that occurred at the site of organic stenosis compared to those with a coronary spasm occurring at a site other than the site of a significant organic stenosis [ 5 , 22 , 58 ].…”

Section: Factors Associated With Long-term Prognosis Of Vsasupporting

confidence: 93%

“…In a study of 1402 Japanese patients with VSA, statin use was associated with a better 5-year, MACE-free survival rate [ 45 ]. However, in a more recent study of 1713 Korean patients with VSA, the use of statins was not related to the long-term prognosis of these patients [ 57 ]. Another Korean study also demonstrated that statin therapy did not improve long-term clinical outcomes in VSA patients without significant organic stenosis [ 70 ].…”

Section: Factors Associated With Long-term Prognosis Of Vsamentioning

confidence: 99%

“…Multi-vessel spasm [28,29,35,53] Myocardial bridging [61] Focal spasm [54][55][56][57] Statin [45,57,[69][70][71]] Calcium channel blocker [5,13,18,35,63] C-reactive protein [23,26,78] Socioeconomic status [18] * Indicates ST elevation, acute coronary syndrome and sudden cardiac death, and ** indicates hypertension, diabetes mellitus and dyslipidemia. VSA, vasospastic angina; ACS, acute coronary syndrome.…”

Section: Intermediate Low Not Relatedmentioning

confidence: 99%

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Current Evidence on Long-Term Prognostic Factors in Vasospastic Angina

Kim

2021

JCM

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Vasospastic angina (VSA) is characterized by a reversible spasm of the coronary arteries and is more prevalent in Asians. Vasodilators, such as calcium channel blockers, are effective in relieving coronary spasms and preventing clinical events. Therefore, the prognosis of VSA is generally known to be better than for significant organic stenosis caused by atherosclerosis. However, coronary vasospasm is sometimes associated with fatal complications such as sudden death, ventricular arrhythmia, and myocardial infarction. Thus, it is very important to identify and actively treat high-risk patients to prevent VSA complications. Here, we will review clinical factors associated with long-term prognosis in patients with VSA.

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Section: Factors Associated With Long-term Prognosis Of Vsasupporting

confidence: 93%

Section: Factors Associated With Long-term Prognosis Of Vsamentioning

confidence: 99%

Section: Intermediate Low Not Relatedmentioning

confidence: 99%

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Current Evidence on Long-Term Prognostic Factors in Vasospastic Angina

Kim

2021

JCM

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“…Based on the sensitivity analysis results, we observed that none of the studies affected the overall effect, indicating that our meta-analysis is statistically stable. But results analyzed in the paper by Seo et al are certainly a cause for concern [ 10 ]. The study included 1658 patients who were diagnosed with CAS based on coronary provocation test and excluded patients who had a history of percutaneous coronary intervention and stroke/transient ischemic attack and ≥50% obstructive CAD.…”

Section: Discussionmentioning

confidence: 99%

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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“…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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Clinical impact of statin therapy on vasospastic angina: data from a Korea nation-wide cohort study

Cited by 14 publications

References 31 publications

Current Evidence on Long-Term Prognostic Factors in Vasospastic Angina

Current Evidence on Long-Term Prognostic Factors in Vasospastic Angina

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

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

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