Impact of Statin Therapy on Clinical Outcome in Patients With Coronary Spasm
BackgroundStatin therapy reduces the risk of cardiovascular events in patients with obstructive coronary artery disease. The aim of the present study was to determine the effects of statins on the prognosis of patients with coronary vasospastic angina (VSA) free of significant atherosclerotic stenos...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2016-05-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.003426 |
| _version_ | 1811275150587330560 |
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| author | Masanobu Ishii Koichi Kaikita Koji Sato Kenshi Yamanaga Takashi Miyazaki Tomonori Akasaka Noriaki Tabata Yuichiro Arima Daisuke Sueta Kenji Sakamoto Eiichiro Yamamoto Kenichi Tsujita Megumi Yamamuro Sunao Kojima Hirofumi Soejima Seiji Hokimoto Kunihiko Matsui Hisao Ogawa |
| author_facet | Masanobu Ishii Koichi Kaikita Koji Sato Kenshi Yamanaga Takashi Miyazaki Tomonori Akasaka Noriaki Tabata Yuichiro Arima Daisuke Sueta Kenji Sakamoto Eiichiro Yamamoto Kenichi Tsujita Megumi Yamamuro Sunao Kojima Hirofumi Soejima Seiji Hokimoto Kunihiko Matsui Hisao Ogawa |
| author_sort | Masanobu Ishii |
| collection | DOAJ |
| description | BackgroundStatin therapy reduces the risk of cardiovascular events in patients with obstructive coronary artery disease. The aim of the present study was to determine the effects of statins on the prognosis of patients with coronary vasospastic angina (VSA) free of significant atherosclerotic stenosis. Methods and ResultsAfter exclusion of 475 from 1877 consecutive patients who underwent an acetylcholine‐provocation test between January 1991 and December 2010, data of 640 VSA patients without significant organic stenosis of the remaining 1402 were analyzed retrospectively. Propensity score matching was performed to reduce the effect of treatment‐selection bias and possible confounders. The primary endpoint was major adverse cardiac events (MACE), including cardiac death, nonfatal myocardial infarction, and unstable angina. Among the study population, dyslipidemia on admission was identified in 160 of 168 (95.2%) patients of the statin group compared with only 125 of 472 (26.5%) of the no‐statin group. Of the 640 patients, 24 (3.8%) developed MACE. Multivariate Cox hazard regression analysis identified statin therapy as a significant negative predictor of MACE (hazard ratio, 0.11; 95% CI, 0.02–0.84; P=0.033). In the propensity‐score matched cohorts (n=128 each), Kaplan–Meier survival curve showed a better 5‐year MACE‐free survival rate for patients of the statin group compared to the no‐statin group (100% vs 91.7%, respectively; P=0.002). ConclusionsStatin therapy correlated with a lower rate of cardiovascular events in VSA patients free of significant organic stenosis. Statins seems to improve the prognosis of VSA patients free of significant organic stenosis. |
| first_indexed | 2024-04-12T23:32:56Z |
| format | Article |
| id | doaj.art-9934726f5c6d4118ab377e2467dd3179 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-12T23:32:56Z |
| publishDate | 2016-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-9934726f5c6d4118ab377e2467dd31792022-12-22T03:12:13ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-05-015510.1161/JAHA.116.003426Impact of Statin Therapy on Clinical Outcome in Patients With Coronary SpasmMasanobu Ishii0Koichi Kaikita1Koji Sato2Kenshi Yamanaga3Takashi Miyazaki4Tomonori Akasaka5Noriaki Tabata6Yuichiro Arima7Daisuke Sueta8Kenji Sakamoto9Eiichiro Yamamoto10Kenichi Tsujita11Megumi Yamamuro12Sunao Kojima13Hirofumi Soejima14Seiji Hokimoto15Kunihiko Matsui16Hisao Ogawa17Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanDepartment of General and Community Medicine, Kumamoto University Hospital, Kumamoto, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, JapanBackgroundStatin therapy reduces the risk of cardiovascular events in patients with obstructive coronary artery disease. The aim of the present study was to determine the effects of statins on the prognosis of patients with coronary vasospastic angina (VSA) free of significant atherosclerotic stenosis. Methods and ResultsAfter exclusion of 475 from 1877 consecutive patients who underwent an acetylcholine‐provocation test between January 1991 and December 2010, data of 640 VSA patients without significant organic stenosis of the remaining 1402 were analyzed retrospectively. Propensity score matching was performed to reduce the effect of treatment‐selection bias and possible confounders. The primary endpoint was major adverse cardiac events (MACE), including cardiac death, nonfatal myocardial infarction, and unstable angina. Among the study population, dyslipidemia on admission was identified in 160 of 168 (95.2%) patients of the statin group compared with only 125 of 472 (26.5%) of the no‐statin group. Of the 640 patients, 24 (3.8%) developed MACE. Multivariate Cox hazard regression analysis identified statin therapy as a significant negative predictor of MACE (hazard ratio, 0.11; 95% CI, 0.02–0.84; P=0.033). In the propensity‐score matched cohorts (n=128 each), Kaplan–Meier survival curve showed a better 5‐year MACE‐free survival rate for patients of the statin group compared to the no‐statin group (100% vs 91.7%, respectively; P=0.002). ConclusionsStatin therapy correlated with a lower rate of cardiovascular events in VSA patients free of significant organic stenosis. Statins seems to improve the prognosis of VSA patients free of significant organic stenosis.https://www.ahajournals.org/doi/10.1161/JAHA.116.003426acetylcholineanginaatherosclerosiscardiovascular diseasecoronary artery diseasestatins |
| spellingShingle | Masanobu Ishii Koichi Kaikita Koji Sato Kenshi Yamanaga Takashi Miyazaki Tomonori Akasaka Noriaki Tabata Yuichiro Arima Daisuke Sueta Kenji Sakamoto Eiichiro Yamamoto Kenichi Tsujita Megumi Yamamuro Sunao Kojima Hirofumi Soejima Seiji Hokimoto Kunihiko Matsui Hisao Ogawa Impact of Statin Therapy on Clinical Outcome in Patients With Coronary Spasm Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acetylcholine angina atherosclerosis cardiovascular disease coronary artery disease statins |
| title | Impact of Statin Therapy on Clinical Outcome in Patients With Coronary Spasm |
| title_full | Impact of Statin Therapy on Clinical Outcome in Patients With Coronary Spasm |
| title_fullStr | Impact of Statin Therapy on Clinical Outcome in Patients With Coronary Spasm |
| title_full_unstemmed | Impact of Statin Therapy on Clinical Outcome in Patients With Coronary Spasm |
| title_short | Impact of Statin Therapy on Clinical Outcome in Patients With Coronary Spasm |
| title_sort | impact of statin therapy on clinical outcome in patients with coronary spasm |
| topic | acetylcholine angina atherosclerosis cardiovascular disease coronary artery disease statins |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.003426 |
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