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急性冠脉综合征

科研文章

荐读文献

The Potential Use of the Index of Microcirculatory Resistance to Guide Stratification of Patients for Adjunctive Therapy in Acute Myocardial Infarction Natural History of Spontaneous Coronary Artery Dissection With Spontaneous Angiographic Healing Transition of Macrophages to Fibroblast-Like Cells in Healing Myocardial Infarction Antiplatelet therapy in patients with myocardial infarction without obstructive coronary artery disease Pharmacotherapy in the Management of Anxiety and Pain During Acute Coronary Syndromes and the Risk of Developing Symptoms of Posttraumatic Stress Disorder Percutaneous Intervention for Concurrent Chronic Total Occlusions in Patients With STEMI: The EXPLORE Trial Morphine and Cardiovascular Outcomes Among Patients With Non-ST-Segment Elevation Acute Coronary Syndromes Undergoing Coronary Angiography Linking Spontaneous Coronary Artery Dissection, Cervical Artery Dissection, and Fibromuscular Dysplasia: Heart, Brain, and Kidneys Myocardial Infarction Risk Stratification With a Single Measurement of High-Sensitivity Troponin I Efficacy and Safety of Low-Dose Colchicine after 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.