Skip to main content
main-content
Top

Tip

Swipe om te navigeren naar een ander artikel

13-12-2017 | Original Article | Uitgave 1/2018 Open Access

Netherlands Heart Journal 1/2018

Long-term outcomes of a Caucasian cohort presenting with acute coronary syndrome and/or out-of-hospital cardiac arrest caused by coronary spasm

Tijdschrift:
Netherlands Heart Journal > Uitgave 1/2018
Auteurs:
W. Vlastra, M. Piek, M. A. van Lavieren, M. E. J. C. Hassell, B. E. Claessen, G. W. Wijntjens, T. P. van de Hoef, K. D Sjauw, M. A. Beijk, R. Delewi, J. J. Piek
Belangrijke opmerkingen
W. Vlastra and M. Piek contributed equally as first authors to this manuscript.

Abstract

Background

Coronary artery spasm may be the underlying mechanism in up to 10% of cases of acute coronary syndrome (ACS) and sudden cardiac death. Asian individuals exhibit a 3-times greater incidence of spasm than Caucasians; this is likely due to different types of mechanisms. Consequently, solid data is limited about the long-term prognosis in Caucasian patients presenting with ACS and/or out-of-hospital cardiac arrest (OHCA) caused by coronary spasm.

Methods

Between 2002 and 2015, thirty Caucasian patients with coronary artery spasm presenting with ACS (N = 29) and/or OHCA (N = 11) were enrolled in this prospective registry. Follow-up, consisting of regular outpatient visits, was conducted with a mean follow-up period of 7.5 ± 3.3 years. Outcomes included presence of stable angina pectoris, recurrence of ACS, occurrence of implantable cardioverter defibrillator (ICD) shocks and death.

Results

The majority of patients (60%) remained asymptomatic during the entire follow-up period. At the end of the follow-up period only 3 patients still experienced stable angina (10%). Only 2 patients (7%) had a recurrent cardiac event, in which the ICD provided appropriate shock therapy. Half of the patients treated with stenting (N = 6), required re-interventions.

Conclusion

Coronary spasm with ACS and/or OHCA in a Caucasian patient cohort has a relatively benign prognosis in the majority of patients in long-term follow-up, if treated appropriately with medical therapy. Both the role of ICD in OHCA secondary to coronary spasm, and the efficacy of stenting to treat vasospastic angina, warrant further study in large-sized prospective clinical trials.

Onze productaanbevelingen

Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

Literatuur
Over dit artikel

Andere artikelen Uitgave 1/2018

Netherlands Heart Journal 1/2018 Naar de uitgave

Image Puzzle – Question

Total eclipse in the heart

Image Puzzle - Answer

Total eclipse in the heart