CBS 2019
CBSMD教育中心
English

Acute Coronary Syndrom

科研文章

荐读文献

Efficacy and Safety of Stents in ST-Segment Elevation Myocardial Infarction Prognostic and Practical Validation of Current Definitions of Myocardial Infarction Associated With Percutaneous Coronary Intervention Canadian SCAD Cohort Study: Shedding Light on SCAD From a United Front Invasive Management of Acute Myocardial Infarction Complicated by Cardiogenic Shock: A Scientific Statement From the American Heart Association Improved outcomes in patients with ST-elevation myocardial infarction during the last 20 years are related to implementation of evidence-based treatments: experiences from the SWEDEHEART registry 1995-2014 Mild Hypothermia in Cardiogenic Shock Complicating Myocardial Infarction - The Randomized SHOCK-COOL Trial Decreased inspired oxygen stimulates de novo formation of coronary collaterals in adult heart Association Between Haptoglobin Phenotype and Microvascular Obstruction in Patients With STEMI: A Cardiac Magnetic Resonance Study Fractional flow reserve vs. angiography in guiding management to optimize outcomes in non-ST-segment elevation myocardial infarction: the British Heart Foundation FAMOUS-NSTEMI randomized trial Epinephrine Versus Norepinephrine for Cardiogenic Shock After Acute Myocardial Infarction

Original Research2019 Mar 9. [Epub ahead of print]

JOURNAL:Am J Cardiol. Article Link

Prevalence of Coronary Vasospasm Using Coronary Reactivity Testing in Patients With Spontaneous Coronary Artery Dissection

Solaru KW, Heupler F, Kim ESH et al. Keywords: spontaneous coronary artery dissection; prevalence; MI, sudden cardiac death; coronary vasospasm

ABSTRACT


Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction and sudden cardiac death, particularly in young to middle-aged women. Coronary vasospasm is another condition believed to be associated with SCAD; however, this has only been shown in isolated case reports to date. We sought to examine the association of SCAD and coronary vasospasm by reporting the experience of coronary vasospasm testing in patients with a history of previous SCAD in a large, tertiary referral center. We conducted a single-center retrospective review of patients with history of SCAD confirmed by angiography who received provocative testing using ergonovine in the Cleveland Clinic cardiac catheterization lab from January 1990 to December 2016. Positive vasospasm was defined as: (1) total or subtotal occlusion of at least 1 major coronary artery induced by administration of ergonovine and (2) resolution of said occlusion with the administration of nitrates. Patients with history of strong trauma to the chest and iatrogenic dissection (e.g., catheter-induced) were excluded from the study. We identified 11 patients who satisfied all inclusion criteria. All participants were women and the mean age was 47 years: 73% received screening for fibromuscular dysplasia and of those, 38% were found to have the diagnosis. Only 1 of 11 patients had a positive vasospasm test in the setting of ergonovine administration in the catheterization lab. In conclusion, we found a low prevalence of coronary vasospasm in individuals with confirmed previous SCAD.