2019
DOI: 10.1097/psy.0000000000000682
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Coronary Artery Spasm, Coronary Reactivity, and Their Psychological Context

Abstract: Symptomatic individuals suspected of having myocardial ischemia often have no obstructive atherosclerotic narrowing of epicardial coronary arteries. Abnormal coronary vascular reactivity, and in particular, coronary artery vasospasm (CAS), may be an explanation in a subset of these patients. Psychological factors play an important role in ischemic heart disease, but their role in CAS is not clear; autonomic dysfunction and increased inflammation are two prevailing pathophysiological mechanisms implicated in ab… Show more

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Cited by 23 publications
(20 citation statements)
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“…We should, however, also recognize limitations in this study inherent with using health insurance claims data, which have been previously pointed out [16]. Some of these are acknowledged by the authors (misclassification, unmeasured confounding, residual confounding) and may have biased results towards the null given that the effect sizes for AMI and stroke were quite small.…”
mentioning
confidence: 81%
“…We should, however, also recognize limitations in this study inherent with using health insurance claims data, which have been previously pointed out [16]. Some of these are acknowledged by the authors (misclassification, unmeasured confounding, residual confounding) and may have biased results towards the null given that the effect sizes for AMI and stroke were quite small.…”
mentioning
confidence: 81%
“…To date, the etiology of CAS following CABG is still not well defined. Some postoperative factors are reported to affect the CAS, including vascular trauma, platelet activation, high local potassium [ 1 , 19 ]. The occurrence of CAS showed no specific sites, such as a site of mild or severe stenosis, or any segment of the coronary arteries with no structural anomaly.…”
Section: Discussionmentioning
confidence: 99%
“…However, it is understood to be caused by impaired vasodilation secondary to smooth muscle hyperactivity and endothelial, autonomic, and microvascular dysfunctions due to the traditional risk factors of coronary artery disease. 6 , 7 Since the episodes of coronary vasospasm are usually temporary, establishing a definite diagnosis of VSA is challenging. However, if VSA is suspected clinically, a provocation test is needed for a precise diagnosis.…”
Section: Discussionmentioning
confidence: 99%