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急性冠脉综合征

科研文章

荐读文献

Prognostic impact of atrial fibrillation in cardiogenic shock complicating acute myocardial infarction: a substudy of the IABP-SHOCK II trial Prognostic impact of non-culprit chronic total occlusions in infarct-related cardiogenic shock: results of the randomised IABP-SHOCK II trial Non-eligibility for reperfusion therapy in patients presenting with ST-segment elevation myocardial infarction: Contemporary insights from the National Cardiovascular Data Registry (NCDR) Fourth Universal Definition of Myocardial Infarction (2018) Risk Stratification for Patients in Cardiogenic Shock After Acute Myocardial Infarction Impact of the US Food and Drug Administration–Approved Sex-Specific Cutoff Values for High-Sensitivity Cardiac Troponin T to Diagnose Myocardial Infarction Improvement of Clinical Outcome in Patients With ST-Elevation Myocardial Infarction Between 1999 And 2016 in China : The Prospective, Multicenter Registry MOODY Study The Wait for High-Sensitivity Troponin Is Over—Proceed Cautiously Respiratory syncytial virus infection and risk of acute myocardial infarction Prognostic Significance of Complex Ventricular Arrhythmias Complicating ST-Segment Elevation 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.