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急性冠脉综合征

科研文章

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Causes of delay and associated mortality in patients transferred with ST-segment-elevation myocardial infarction High-Sensitivity Troponins and Outcomes After Myocardial Infarction Cardiovascular Mortality After Type 1 and Type 2 Myocardial Infarction in Young Adults Management of Acute Myocardial Infarction During the COVID-19 Pandemic Improved Outcomes Associated with the use of Shock Protocols: Updates from the National Cardiogenic Shock Initiative Canadian SCAD Cohort Study: Shedding Light on SCAD From a United Front Patterns of use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers among patients with acute myocardial infarction in China from 2001 to 2011: China PEACE-Retrospective AMI Study Prognostic Value of the Residual SYNTAX Score After Functionally Complete Revascularization in ACS Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome How Will the Transition to hs-cTn Affect the Diagnosis of Type 1 and 2 MI?

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.