Author + information
- Received September 24, 2014
- Revision received December 16, 2014
- Accepted December 18, 2014
- Published online June 1, 2015.
- Dong IL Shin, MD∗,
- Sang Hong Baek, MD†∗ (, )
- Sung Ho Her, MD‡,
- Seung Hwan Han, MD§,
- Youngkeun Ahn, MD‖,
- Keun-Ho Park, MD‖,
- Dong-Soo Kim, MD¶,
- Tae-Hyun Yang, MD¶,
- Dong-Ju Choi, MD#,
- Jung-Won Suh, MD#,
- Hyuck Moon Kwon, MD∗∗,
- Byoung Kwon Lee, MD∗∗,
- Hyeon-Cheol Gwon, MD††,
- Seung-Woon Rha, MD‡‡ and
- Sang-Ho Jo, MD§§
- ∗Department of Cardiovascular Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Incheon, South Korea
- †Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea
- ‡Daejeon St. Mary’s Hospital, The Catholic University of Korea, Daejeon, South Korea
- §Gil Medical Center, Gachon University, Incheon, South Korea
- ‖Chonnam National University Hospital, Chonnam National University, Gwangju, South Korea
- ¶Busan Paik Hospital, Inje University, Busan, South Korea
- #Bundang Hospital, Seoul National University, Seongnam, South Korea
- ∗∗Gangnam Severance Hospital, Yonsei University, Seoul, South Korea
- ††Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
- ‡‡Guro Hospital, Korea University, Seoul, South Korea
- §§Pyeongchon Sacred Heart Hospital, Hallym University, Anyang, South Korea
- ↵∗Reprint requests and correspondence:
Dr. Sang Hong Baek, Department of Cardiovascular Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-ku, Seoul 137-040, South Korea.
Objectives This study was an observational, multicenter registry to determine clinical characteristics and 24-month prognosis of patients who underwent intracoronary ergonovine provocation tests.
Background The clinical characteristics and prognosis of patients who underwent the ergonovine provocation for vasospastic angina were not fully elucidated.
Methods A total of 2,129 patients in the VA-KOREA (Vasospastic Angina in Korea) registry were classified into positive (n = 454), intermediate (n = 982), and negative (n = 693) groups by intracoronary ergonovine provocation tests. The 24-month incidences of cardiac death, new-onset arrhythmia, and acute coronary syndrome were determined (mean 26.7 ± 8.8 months).
Results The number of smokers, frequency of angina before angiography, high-sensitivity C-reactive protein, and triglyceride were higher in the positive group than in other groups. The clinical characteristics of the intermediate and the negative groups were very similar. In the positive group, the incidences of diffuse, focal, and mixed spasm were 65.9%, 23.6%, and 10.6%. Coronary spasm was more frequently provoked on atherosclerotic segments. The 24-month incidences of cardiac death, arrhythmia, and acute coronary syndrome were low (0.9%, 1.6%, and 1.9%, respectively) in the positive group, and there was no cardiac death in the intermediate group (p = 0.02). In the positive group, frequent angina, current smoking, and multivessel spasm were independent predictors for adverse events.
Conclusions The 24-month prognosis of the positive group in the intracoronary ergonovine provocation test was relatively worse than that of the intermediate group. More intensive clinical attention should be paid to vasospastic angina patients with high-risk factors including frequent angina before angiography, current smoking, and multivessel spasm.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received September 24, 2014.
- Revision received December 16, 2014.
- Accepted December 18, 2014.
- American College of Cardiology Foundation