OBJECTIVES: A retrospective study was conducted to elucidate contributing factors on the outcome of patients with vasospastic angina. SUBJECTS AND METHODS: Two hundred ninety-two patients with angina in whom coronary vasospasm was documented were followed up (mean 4.3+/-3.6 years) to determine the relationship between the occurrence of cardiovascular events with available clinical factors including therapeutic drugs. Cardiovascular events were defined as fatal and non-fatal cardiovascular disorder events. RESULTS: Several clinical variables including age, elevated creatinine level, low high-density lipoprotein (HDL) cholesterol level, presence of severe coronary artery stenosis, low left ventricular ejection fraction, low cardiac index (CI), large left ventricular mass, and use of beta-blockers proved to be significant risk factors for cardiovascular events. Further analysis by a stepwise regression analysis revealed that, older age (hazard ratio (HR)=1.42), low HDL cholesterol level (HR=0.877), presence of severe coronary artery stenosis (HR=49.32), and decreased CI (HR=14.18) proved to be independent prognostic factors. Ca antagonists were prescribed to 261 patients (89.4%). Among four Ca antagonists, there were significant differences in the frequency of cardiovascular events (2.6% with benidipine, 4.2% with nifedipine, 6.0% with diltiazem, 23.1% with amlodipine; amlodipine vs. benidipine, P<0.05) although the background characteristics of the four different patient groups were non-equivalent. CONCLUSION: These results indicate that the morbidity of patients with vasospastic angina increased with older age, lower CI or HDL cholesterol, and presence of severe coronary artery stenosis, and that treatment with benidipine appeared to reduce cardiovascular events in patients with vasospastic angina.
OBJECTIVES: A retrospective study was conducted to elucidate contributing factors on the outcome of patients with vasospastic angina. SUBJECTS AND METHODS: Two hundred ninety-two patients with angina in whom coronary vasospasm was documented were followed up (mean 4.3+/-3.6 years) to determine the relationship between the occurrence of cardiovascular events with available clinical factors including therapeutic drugs. Cardiovascular events were defined as fatal and non-fatal cardiovascular disorder events. RESULTS: Several clinical variables including age, elevated creatinine level, low high-density lipoprotein (HDL) cholesterol level, presence of severe coronary artery stenosis, low left ventricular ejection fraction, low cardiac index (CI), large left ventricular mass, and use of beta-blockers proved to be significant risk factors for cardiovascular events. Further analysis by a stepwise regression analysis revealed that, older age (hazard ratio (HR)=1.42), low HDL cholesterol level (HR=0.877), presence of severe coronary artery stenosis (HR=49.32), and decreased CI (HR=14.18) proved to be independent prognostic factors. Ca antagonists were prescribed to 261 patients (89.4%). Among four Ca antagonists, there were significant differences in the frequency of cardiovascular events (2.6% with benidipine, 4.2% with nifedipine, 6.0% with diltiazem, 23.1% with amlodipine; amlodipine vs. benidipine, P<0.05) although the background characteristics of the four different patient groups were non-equivalent. CONCLUSION: These results indicate that the morbidity of patients with vasospastic angina increased with older age, lower CI or HDL cholesterol, and presence of severe coronary artery stenosis, and that treatment with benidipine appeared to reduce cardiovascular events in patients with vasospastic angina.