Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis
Background: It has been reported that significant endothelial dysfunction or clinically evident vasospasm can be associated with drug-eluting stents (DESs). However, the impact of DES associated coronary artery spasm (CAS) on long-term clinical outcomes has not been fully elucidated as compared with...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-05-01
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| Series: | Indian Heart Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483222000748 |
| _version_ | 1818251566582333440 |
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| author | Jabar Ali Seung-Woon Rha Byoung Geol Choi Jae Kyeong Byun Se Yeon Choi Jin Ah Cha Soohyung Park Kyuho Lee Seungmin Back Jieun Lee Dong Oh Kang Jah Yeon Choi Seung-Young Roh Jin Oh Na Cheol Ung Choi Jin-Won Kim Eung Ju Kim Chang Gyu Park Hong Seog Seo Mohammad Wasim Zair Hassan |
| author_facet | Jabar Ali Seung-Woon Rha Byoung Geol Choi Jae Kyeong Byun Se Yeon Choi Jin Ah Cha Soohyung Park Kyuho Lee Seungmin Back Jieun Lee Dong Oh Kang Jah Yeon Choi Seung-Young Roh Jin Oh Na Cheol Ung Choi Jin-Won Kim Eung Ju Kim Chang Gyu Park Hong Seog Seo Mohammad Wasim Zair Hassan |
| author_sort | Jabar Ali |
| collection | DOAJ |
| description | Background: It has been reported that significant endothelial dysfunction or clinically evident vasospasm can be associated with drug-eluting stents (DESs). However, the impact of DES associated coronary artery spasm (CAS) on long-term clinical outcomes has not been fully elucidated as compared with those of patients with vasospastic angina. Methods: A total of 2797 consecutive patients without significant coronary artery lesion (<70%), who underwent the Acetylcholine (Ach) provocation test, were enrolled between Nov 2004 and Oct 2010. DES-associated spasm was defined as significant CAS in proximal or distal to previously implanted DES site at follow-up angiography with Ach test. Patients were divided into two groups (DES-CAS; n = 108, CAS; n = 1878). For adjustment, propensity score matching (PSM) was done (C-statistics = 0.766, DES-CAS; n = 102, CAS; n = 102). SPSS 20 (Inc., Chicago, Illinois) was used to analyze this data. Results: Baseline characteristics were worse in the DES-CAS group. After PSM, both baseline characteristics and the Ach test results were balanced except higher incidence of diffuse CAS and ECG change in the DES-CAS group. During Ach test, the incidence of diffuse spasm (93.1% vs. 81.3%, p = 0.012) and ST-T change (10.7% vs. 1.9%, p = 0.010) were higher in the DES-CAS group. At 3-year, before and after adjustment, the DES-CAS group showed a higher incidence of coronary revascularization (9.8% vs. 0.0%, p = 0.001), recurrent chest pain requiring follow up coronary angiography (CAG, 24.5% vs. 7.8%, p = 0.001) and major adverse cardiac events (MACEs, 9.8% vs. 0.9%, p < 0.005). Conclusion: In this study, DES associated CAS was associated with higher incidence of diffuse spasm, ST-T change and adverse 3-year clinical outcomes. Special caution should be exercised in this particular subset of patients. |
| first_indexed | 2024-12-12T16:10:19Z |
| format | Article |
| id | doaj.art-7da85cf4eb2e416bbb61296bc2e52ae5 |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-12-12T16:10:19Z |
| publishDate | 2022-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-7da85cf4eb2e416bbb61296bc2e52ae52022-12-22T00:19:13ZengElsevierIndian Heart Journal0019-48322022-05-01743182186Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysisJabar Ali0Seung-Woon Rha1Byoung Geol Choi2Jae Kyeong Byun3Se Yeon Choi4Jin Ah Cha5Soohyung Park6Kyuho Lee7Seungmin Back8Jieun Lee9Dong Oh Kang10Jah Yeon Choi11Seung-Young Roh12Jin Oh Na13Cheol Ung Choi14Jin-Won Kim15Eung Ju Kim16Chang Gyu Park17Hong Seog Seo18Mohammad Wasim19Zair Hassan20MBBS, MCPS (medicine), FCPS Cardiology, Fellowship in Coronary and Peripheral Intervention, Seoul, South Korea; Assistant Professor Cardiology, Department of Cardiology, MTI Lady Reading Hospital Peshawar, PakistanCardiovascular Center, Korea University Guro Hospital, Seoul, South Korea; Corresponding author. Cardiovascular Center, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul, 08308, South Korea.Cardiovascular Research Institute, Korea University College of Medicine, Seoul, South KoreaCardiovascular Research Institute, Korea University College of Medicine, Seoul, South KoreaCardiovascular Research Institute, Korea University College of Medicine, Seoul, South KoreaDepartment of Biomedical Sciences, Korea University Graduate School, Seoul, South KoreaCardiovascular Center, Korea University Guro Hospital, Seoul, South KoreaCardiovascular Center, Korea University Guro Hospital, Seoul, South KoreaCardiovascular Center, Korea University Guro Hospital, Seoul, South KoreaCardiovascular Center, Korea University Guro Hospital, Seoul, South KoreaCardiovascular Center, Korea University Guro Hospital, Seoul, South KoreaCardiovascular Center, Korea University Guro Hospital, Seoul, South KoreaCardiovascular Center, Korea University Guro Hospital, Seoul, South KoreaCardiovascular Center, Korea University Guro Hospital, Seoul, South KoreaCardiovascular Center, Korea University Guro Hospital, Seoul, South KoreaCardiovascular Center, Korea University Guro Hospital, Seoul, South KoreaCardiovascular Center, Korea University Guro Hospital, Seoul, South KoreaCardiovascular Center, Korea University Guro Hospital, Seoul, South KoreaCardiovascular Center, Korea University Guro Hospital, Seoul, South KoreaMBBS, Postgraduate Trainee Cardiology Department of Cardiology, Lady Reading Hospital, Peshawar PakistanMBBS, Postgraduate Trainee Cardiology Department of Cardiology, Lady Reading Hospital, Peshawar PakistanBackground: It has been reported that significant endothelial dysfunction or clinically evident vasospasm can be associated with drug-eluting stents (DESs). However, the impact of DES associated coronary artery spasm (CAS) on long-term clinical outcomes has not been fully elucidated as compared with those of patients with vasospastic angina. Methods: A total of 2797 consecutive patients without significant coronary artery lesion (<70%), who underwent the Acetylcholine (Ach) provocation test, were enrolled between Nov 2004 and Oct 2010. DES-associated spasm was defined as significant CAS in proximal or distal to previously implanted DES site at follow-up angiography with Ach test. Patients were divided into two groups (DES-CAS; n = 108, CAS; n = 1878). For adjustment, propensity score matching (PSM) was done (C-statistics = 0.766, DES-CAS; n = 102, CAS; n = 102). SPSS 20 (Inc., Chicago, Illinois) was used to analyze this data. Results: Baseline characteristics were worse in the DES-CAS group. After PSM, both baseline characteristics and the Ach test results were balanced except higher incidence of diffuse CAS and ECG change in the DES-CAS group. During Ach test, the incidence of diffuse spasm (93.1% vs. 81.3%, p = 0.012) and ST-T change (10.7% vs. 1.9%, p = 0.010) were higher in the DES-CAS group. At 3-year, before and after adjustment, the DES-CAS group showed a higher incidence of coronary revascularization (9.8% vs. 0.0%, p = 0.001), recurrent chest pain requiring follow up coronary angiography (CAG, 24.5% vs. 7.8%, p = 0.001) and major adverse cardiac events (MACEs, 9.8% vs. 0.9%, p < 0.005). Conclusion: In this study, DES associated CAS was associated with higher incidence of diffuse spasm, ST-T change and adverse 3-year clinical outcomes. Special caution should be exercised in this particular subset of patients.http://www.sciencedirect.com/science/article/pii/S0019483222000748DESDrug eluting stentsCASCoronary artery spasmAch: acetylcholineMACE |
| spellingShingle | Jabar Ali Seung-Woon Rha Byoung Geol Choi Jae Kyeong Byun Se Yeon Choi Jin Ah Cha Soohyung Park Kyuho Lee Seungmin Back Jieun Lee Dong Oh Kang Jah Yeon Choi Seung-Young Roh Jin Oh Na Cheol Ung Choi Jin-Won Kim Eung Ju Kim Chang Gyu Park Hong Seog Seo Mohammad Wasim Zair Hassan Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis Indian Heart Journal DES Drug eluting stents CAS Coronary artery spasm Ach: acetylcholine MACE |
| title | Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis |
| title_full | Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis |
| title_fullStr | Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis |
| title_full_unstemmed | Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis |
| title_short | Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis |
| title_sort | impact of drug eluting stent associated coronary artery spasm on 3 year clinical outcomes a propensity score matching analysis |
| topic | DES Drug eluting stents CAS Coronary artery spasm Ach: acetylcholine MACE |
| url | http://www.sciencedirect.com/science/article/pii/S0019483222000748 |
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