To assess whether treatment of coronary vasospastic angina with anti-spastic agents (calcium channel blockers and/or isosorbide dinitrate) can reduce the level of inflammation in patients with coronary vasospasm and no hemodynamically significant coronary artery disease.
Patients with a diagnosis of coronary vasospasm by intracoronary ergonovine testing were enrolled as the study group and patients who had no provoked coronary vasospasm as the control group. High-sensitivity C-reactive protein (hsCRP) levels were obtained before coronary angiography and 3 months after treatment with anti-spastic agents.
There were 27 patients in the coronary vasospasm group and 29 patients in the control group. The proportions of the highest tertile of peripheral monocyte count and serum hsCRP level were significantly (p<0.001) elevated in the coronary vasospasm group. Multivariate analysis showed that hsCRP was independently associated with a diagnosis of coronary vasospastic angina (odds ratio = 5.44, 95% confidence interval = 1.60-18.47, p =0.007). In the coronary vasospasm group, the initial mean level of hsCRP was 8.17 mg/l in the coronary vasospasm group and decreased significantly (p=0.001) to 2.95 mg/l 3 months after treatment. The level of hsCRP in the coronary vasospasm group after 3 months’ treatment was still significantly higher (p<0.001) than the baseline hsCRP level in the control group.
This study demonstrated that treatment with anti-spastic agents decreases the inflammation status of coronary vasospasm in these patients as evidenced by hsCRP level.
Coronary vasospasm with no hemodynamically significant coronary artery disease is an inflammatory coronary artery disease.
M. Hung, None.