Vasospastic angina: Past, present, and future

He, Zuowen; Xu, Xin; Zhao, Qi; Ding, Hu; Wang, Dao Wen

doi:10.1016/j.pharmthera.2023.108500

Cited by 5 publications

(1 citation statement)

References 231 publications

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“…Both DHP and non-DHP CCBs have been proven to reduce the frequency and intensity of angina episodes along with the occurrence of MI and life-threatening arrhythmias [ 143 , 144 , 145 , 146 ]. A recent meta-analysis found that benidipine, a second-generation of DHP CCB with high affinity for the coronary vessels, might be the most effective CCB for improving both symptoms control and outcomes [ 147 ].…”

Section: Therapymentioning

confidence: 99%

Coronary Spasm Testing with Acetylcholine: A Powerful Tool for a Personalized Therapy of Coronary Vasomotor Disorders

Gurgoglione,

Vignali,

Montone

et al. 2024

Life

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Coronary vasomotor disorders (CVD) are characterized by transient hypercontraction of coronary vascular smooth muscle cells, leading to hypercontraction of epicardial and/or microvascular coronary circulation. CVDs play a relevant role in the pathogenesis of ischemia, angina and myocardial infarction with non-obstructive coronary arteries. Invasive provocative testing with intracoronary Acetylcholine (ACh) administration is the gold standard tool for addressing CVD, providing relevant therapeutic and prognostic implications. However, safety concerns preclude the widespread incorporation of the ACh test into clinical practice. The purpose of this review is to shed light on the pathophysiology underlying CVD and on the clinical role of the ACh test, focusing on safety profile and prognostic implications. We will also discuss contemporary evidence on the management of CVD and the role of the ACh test in driving a personalized approach of patients with CVD.

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Section: Therapymentioning

confidence: 99%

Coronary Spasm Testing with Acetylcholine: A Powerful Tool for a Personalized Therapy of Coronary Vasomotor Disorders

Gurgoglione,

Vignali,

Montone

et al. 2024

Life

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Anji white tea relaxes precontracted arteries, represses voltage-gated Ca2+ channels and voltage-gated K+ channels in the arterial smooth muscle cells: Comparison with green tea main component (−)-epigallocatechin gallate

Xu,

Fan,

Yang

et al. 2024

Journal of Ethnopharmacology

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Coronary vasomotor response incidence to intracoronary acetylcholine provocation test according to the severity of insignificant coronary artery stenosis in Korean population

Park,

Ahn,

Rha

et al. 2024

Coronary Artery Disease

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Background Coronary artery spasm (CAS) is a cause of variant angina. However, the understanding of CAS patterns in the presence of mild-to-moderate coronary artery stenosis is limited. This study aimed to evaluate the incidence and patterns of CAS in patients with insignificant coronary artery stenosis using intracoronary acetylcholine (ACH) provocation test. Methods In this study, 6513 patients without significant coronary artery stenosis who underwent intracoronary ACH provocation test were enrolled. Patients were divided into three groups, based on the severity of coronary artery stenosis: the non group (stenosis <30%, n = 2833), the mild group (30–49%, n = 3278) and the moderate group (50–69%, n = 402). Vasomotor responses were observed among three different groups. Results The baseline characteristics of the patients in the mild and moderate groups were worse than in the non group. They were older, had higher prevalence of hypertension, diabetes, dyslipidemia, and smoking habit. During the ACH test, CAS was observed in 58.1% of the overall population. The mild group (60.1%) and the moderate group (60.9%) showed a higher incidence than the non group (55.3%, P < 0.001). In addition, among cases of CAS, the mild group (3.2%) and the moderate group (8.5%) responded more at a lowest dose of ACH than the non group (3.1%, P < 0.001). Conclusion In patients with chest pain without significant coronary artery stenosis, CAS was observed in over half of the cases. Furthermore, CAS was found to be more frequent and more susceptible in patients with mild-to-moderate coronary artery stenosis compared with those without fixed stenosis.

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Vasospastic angina: Past, present, and future

Cited by 5 publications

References 231 publications

Coronary Spasm Testing with Acetylcholine: A Powerful Tool for a Personalized Therapy of Coronary Vasomotor Disorders

Coronary Spasm Testing with Acetylcholine: A Powerful Tool for a Personalized Therapy of Coronary Vasomotor Disorders

Anji white tea relaxes precontracted arteries, represses voltage-gated Ca2+ channels and voltage-gated K+ channels in the arterial smooth muscle cells: Comparison with green tea main component (−)-epigallocatechin gallate

Coronary vasomotor response incidence to intracoronary acetylcholine provocation test according to the severity of insignificant coronary artery stenosis in Korean population

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