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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...

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Autores principales: Ali, Jabar, Rha, Seung-Woon, Choi, Byoung Geol, Byun, Jae Kyeong, Choi, Se Yeon, Cha, Jin Ah, Park, Soohyung, Lee, Kyuho, Back, Seungmin, Lee, Jieun, Kang, Dong Oh, Choi, Jah Yeon, Roh, Seung-Young, Na, Jin Oh, Choi, Cheol Ung, Kim, Jin-Won, Kim, Eung Ju, Park, Chang Gyu, Seo, Hong Seog, Wasim, Mohammad, Hassan, Zair
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9243619/
https://www.ncbi.nlm.nih.gov/pubmed/35576993
http://dx.doi.org/10.1016/j.ihj.2022.05.002
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author Ali, Jabar
Rha, Seung-Woon
Choi, Byoung Geol
Byun, Jae Kyeong
Choi, Se Yeon
Cha, Jin Ah
Park, Soohyung
Lee, Kyuho
Back, Seungmin
Lee, Jieun
Kang, Dong Oh
Choi, Jah Yeon
Roh, Seung-Young
Na, Jin Oh
Choi, Cheol Ung
Kim, Jin-Won
Kim, Eung Ju
Park, Chang Gyu
Seo, Hong Seog
Wasim, Mohammad
Hassan, Zair
author_facet Ali, Jabar
Rha, Seung-Woon
Choi, Byoung Geol
Byun, Jae Kyeong
Choi, Se Yeon
Cha, Jin Ah
Park, Soohyung
Lee, Kyuho
Back, Seungmin
Lee, Jieun
Kang, Dong Oh
Choi, Jah Yeon
Roh, Seung-Young
Na, Jin Oh
Choi, Cheol Ung
Kim, Jin-Won
Kim, Eung Ju
Park, Chang Gyu
Seo, Hong Seog
Wasim, Mohammad
Hassan, Zair
author_sort Ali, Jabar
collection PubMed
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.
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spelling pubmed-92436192022-07-01 Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis Ali, Jabar Rha, Seung-Woon Choi, Byoung Geol Byun, Jae Kyeong Choi, Se Yeon Cha, Jin Ah Park, Soohyung Lee, Kyuho Back, Seungmin Lee, Jieun Kang, Dong Oh Choi, Jah Yeon Roh, Seung-Young Na, Jin Oh Choi, Cheol Ung Kim, Jin-Won Kim, Eung Ju Park, Chang Gyu Seo, Hong Seog Wasim, Mohammad Hassan, Zair Indian Heart J Original Article 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. Elsevier 2022 2022-05-13 /pmc/articles/PMC9243619/ /pubmed/35576993 http://dx.doi.org/10.1016/j.ihj.2022.05.002 Text en © 2022 Published by Elsevier, a division of RELX India, Pvt. Ltd on behalf of Cardiological Society of India. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Ali, Jabar
Rha, Seung-Woon
Choi, Byoung Geol
Byun, Jae Kyeong
Choi, Se Yeon
Cha, Jin Ah
Park, Soohyung
Lee, Kyuho
Back, Seungmin
Lee, Jieun
Kang, Dong Oh
Choi, Jah Yeon
Roh, Seung-Young
Na, Jin Oh
Choi, Cheol Ung
Kim, Jin-Won
Kim, Eung Ju
Park, Chang Gyu
Seo, Hong Seog
Wasim, Mohammad
Hassan, Zair
Impact of drug-eluting stent-associated coronary artery spasm on 3-year clinical outcomes: A propensity score matching analysis
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 Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9243619/
https://www.ncbi.nlm.nih.gov/pubmed/35576993
http://dx.doi.org/10.1016/j.ihj.2022.05.002
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