OBJECTIVES: The purpose of this study was to determine whether a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) suppresses coronary spasm. BACKGROUND:Coronary spasm is associated with endothelial dysfunction. Statins have been shown to improve endothelial function. METHODS: This was a prospective, randomized, open-label, end point study. Sixty-four patients who had no significant organic coronary stenosis and in whom coronary spasm was induced by intracoronary injection of acetylcholine (ACh) were randomly assigned to fluvastatin 30 mg/day plus the conventional calcium-channel blocker (CCB) therapy (31 patients, statin group) or the conventional CCB therapy (33 patients, nonstatin group). After 6 months of treatment, the intracoronary injection of ACh was repeated and the coronary spasm was assessed. RESULTS:Coronary spasm was suppressed in 16 of the 31 patients (51.5%, p < 0.0001) of the statin group and in 7 of the 33 patients (21.2%, p = 0.0110) of the nonstatin group after 6 months of treatment. Thus, the number of patients with ACh-induced coronary spasm was significantly reduced in the statin group as compared with the nonstatin group (51.6% vs. 21.2%, p = 0.0231) after 6 months of treatment. CONCLUSIONS: The addition of fluvastatin 30 mg/day to the conventional CCB therapy for 6 months significantly reduced the number of patients with ACh-induced coronary spasm as compared with the conventional CCB therapy. Thus, a statin (fluvastatin) may possibly be a novel therapeutic drug for coronary spasm.
RCT Entities:
OBJECTIVES: The purpose of this study was to determine whether a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) suppresses coronary spasm. BACKGROUND:Coronary spasm is associated with endothelial dysfunction. Statins have been shown to improve endothelial function. METHODS: This was a prospective, randomized, open-label, end point study. Sixty-four patients who had no significant organic coronary stenosis and in whom coronary spasm was induced by intracoronary injection of acetylcholine (ACh) were randomly assigned to fluvastatin 30 mg/day plus the conventional calcium-channel blocker (CCB) therapy (31 patients, statin group) or the conventional CCB therapy (33 patients, nonstatin group). After 6 months of treatment, the intracoronary injection of ACh was repeated and the coronary spasm was assessed. RESULTS:Coronary spasm was suppressed in 16 of the 31 patients (51.5%, p < 0.0001) of the statin group and in 7 of the 33 patients (21.2%, p = 0.0110) of the nonstatin group after 6 months of treatment. Thus, the number of patients with ACh-induced coronary spasm was significantly reduced in the statin group as compared with the nonstatin group (51.6% vs. 21.2%, p = 0.0231) after 6 months of treatment. CONCLUSIONS: The addition of fluvastatin 30 mg/day to the conventional CCB therapy for 6 months significantly reduced the number of patients with ACh-induced coronary spasm as compared with the conventional CCB therapy. Thus, a statin (fluvastatin) may possibly be a novel therapeutic drug for coronary spasm.
Authors: Janet Wei; Puja K Mehta; B Delia Johnson; Bruce Samuels; Saibal Kar; R David Anderson; Babak Azarbal; John Petersen; Barry Sharaf; Eileen Handberg; Chrisandra Shufelt; Kamlesh Kothawade; George Sopko; Amir Lerman; Leslee Shaw; Sheryl F Kelsey; Carl J Pepine; C Noel Bairey Merz Journal: JACC Cardiovasc Interv Date: 2012-06 Impact factor: 11.195
Authors: Shi Hyun Rhew; Youngkeun Ahn; Eun Ae Cho; Min Sok Kim; Su Young Jang; Ki Hong Lee; Min Goo Lee; Keun Ho Park; Doo Sun Sim; Young Joon Hong; Ju Han Kim; Myung Ho Jeong Journal: Korean Circ J Date: 2013-01-31 Impact factor: 3.243