Impact of high-density lipoprotein cholesterol level in patients with variant angina pectoris

Sugano, Yasuo; Anzai, Toshihisa; Yagi, Takashi; Noma, Shigetaka

doi:10.1016/j.ijcard.2008.11.053

Cited by 10 publications

(3 citation statements)

References 37 publications

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“…Several studies have reported predictive serum markers that may be useful for diagnosing coronary spasms. Those markers included C-reactive protein [25], uric acid [26], and lipid abnormalities, like low HDL-C [27]. Similar to previous studies, our analysis showed that smoking, male gender, and low HDL-C levels were common in patients with coronary spasms; however, we found that MDA-LDL was the most powerful predictor of coronary artery spasms.…”

Section: Potential Of Mda-ldl As a Predictor Of Coronary Spasmsupporting

confidence: 88%

Increased circulating malondialdehyde-modified low-density lipoprotein levels in patients with ergonovine-induced coronary artery spasm

Ito

Fujita

Tani

et al. 2015

International Journal of Cardiology

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Section: Potential Of Mda-ldl As a Predictor Of Coronary Spasmsupporting

confidence: 88%

Increased circulating malondialdehyde-modified low-density lipoprotein levels in patients with ergonovine-induced coronary artery spasm

Ito

Fujita

Tani

et al. 2015

International Journal of Cardiology

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“…Nevertheless, this study showed that smoking and low HDL-cholesterolaemia may be possible risk factors for the unavoidable use of NTG, not to mention the risk of coronary spasm from smoking [ 5 , 6 ], which is listed as the first condition to be addressed [ 3 ] and is no doubt involved in the highly active state of coronary spasm. Conversely, some studies have shown that low HDL-cholesterolaemia is a risk factor for coronary spasm [ 23 , 24 ]; nevertheless, smoking has been found to cause low HDL-cholesterolaemia [ 25 ] and is likely to be the main risk factor in this study. In any case, further careful evaluation of risk factors for the unavoidable use of NTG needs to be conducted in future studies.…”

Section: Discussionmentioning

confidence: 55%

Clinical Characteristics and Prognosis of Patients with Vasospastic Angina Subjected to the Spasm Provocation Test and the Unavoidable Use of Nitroglycerin

Teragawa

Oshita

Uchimura

2023

JCDD

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Background: Multi-vessel spasm (MVS) has a prognostic impact in patients with vasospastic angina (VSA). Thus, the presence of coronary spasm in both the left coronary artery (LCA) and right coronary artery (RCA) should be assessed through the spasm provocation test (SPT). Nitroglycerin (NTG) is used to avoid SPT-related complications; however, this unavoidable use of NTG may decrease the detection of MVS. Therefore, we investigated the frequency of the unavoidable use of NTG during SPT and clarified the clinical characteristics in patients with VSA who underwent the unavoidable use of NTG during STP. Methods: A total of 141 patients with positive SPT were evaluated. A positive SPT was defined as > 90% constriction in epicardial coronary arteries in response to acetylcholine, accompanied by the usual chest symptoms and/or ischaemic ST-T changes on electrocardiography. When a coronary spasm occurred, we usually wait for the spontaneous relief of the coronary spasm. However, if a prolonged coronary spasm or unstable haemodynamics occurred, 0.3 mg NTG was administered intracoronarily to promptly relieve the coronary spasm and this was defined as the unavoidable use of NTG. Even when the unavoidable use of NTG was administered in one coronary artery, an additional SPT was performed on another coronary artery. If a coronary spasm occurred in another coronary artery, a positive SPT was diagnosed. In contrast, if a coronary spasm was not induced after the unavoidable use of NTG, the judgement was classified as undiagnosed. The patients were divided into two groups according to the unavoidable use of NTG: U-NTG (n = 42) and the final use of NTG: F-NTG (n = 99). The clinical characteristics and frequencies of MVS (≥2 major coronary arteries in which a coronary spasm was provoked) and complications (malignant arrhythmia and unstable haemodynamics requiring catecholamines) during the SPT were compared between the groups. Results: Except for smoking status, all other clinical characteristics did not differ significantly between the groups. More current smokers were observed in the U-NTG group (29%) than in the F-NTG group (12%, p = 0.02). The frequency of MVS did not vary significantly between the groups (p = 0.28), with 64% for U-NTG and 55% for F-NTG. No significant difference was found between the groups in the frequency of severe complications during SPT (p = 0.83), with 2% for U-NTG and 3% for F-NTG. In the U-NTG group, the positive induction rate of coronary spasm in another coronary artery was 40% (17/42). Conclusions: The unavoidable use of NTG occurred in ~30% of patients with VSA, most of whom were current smokers. It did not decrease the detection of MVS and potentially prevented severe complications during SPT. Therefore, the unavoidable use of NTG is acceptable during SPT. However, an additional test may need to be performed to assess the presence of MVS.

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“…Second, our patient had a low HDL. Sugano et al have shown that patients with an HDL less than 43 mg/dL are 3.39 times more likely to have variant angina [18]. Third, during rewarming our patient had a magnesium of 1.7 mg/dL.…”

mentioning

confidence: 57%

Acquired von Willebrand disease in Jarvik 2000 recipients: A single center experience

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Repessé

Belin

et al. 2012

International Journal of Cardiology

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Impact of high-density lipoprotein cholesterol level in patients with variant angina pectoris

Cited by 10 publications

References 37 publications

Increased circulating malondialdehyde-modified low-density lipoprotein levels in patients with ergonovine-induced coronary artery spasm

Increased circulating malondialdehyde-modified low-density lipoprotein levels in patients with ergonovine-induced coronary artery spasm

Clinical Characteristics and Prognosis of Patients with Vasospastic Angina Subjected to the Spasm Provocation Test and the Unavoidable Use of Nitroglycerin

Acquired von Willebrand disease in Jarvik 2000 recipients: A single center experience

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