Impact of Coronary Artery Fixed Lesion on 3-years Clinical Outcomes in Vasospastic Angina Patients with Myocardial Bridge

초록

Background: It is not known whether the presence of angiographic fixed coronary lesion (FCL) can negatively impact on long-term major clinical outcomes in vasospastic angina patients (pts) with myocardial bridge (MB). Methods: A total 5,882 patients (pts) underwent coronary angiography with acetylcholine (Ach) provocation test from Nov 2004 to Oct 2010. Among them, total 563 pts who had MB and documented significant coronary artery spasm (CAS) by Ach provocation test were enrolled. Study populations were categorized into two groups; the fixed coronary lesion (FCL) group (n=216) and the non-FCL group (n=347). Cumulative major clinical outcomes were compared between the two groups up to 3 years. Results: Baseline characteristics were similar between the two groups except the incidence of elderly, hypertension, diabetes, and dyslipidemia were higher in the FCL group. In univariate analysis, only the composite end-point consisted of cardiac death, de Novo percutaneous coronary intervention (PCI), myocardial infarction (MI), and cerebrovascular accident (CVA) was higher in FCL group (Table). However, in multivariate regression analysis, the incidences of cardiac death, PCI, MI, CVA, recurrent chest pain, and other composite end-points were similar between the two groups up to 3 years. Conclusions: In our study, the presence of angiographic fixed coronary lesion in vasospastic angina pts with MB was not a predictor of adverse long-term clinical outcomes.