Clinical significance of prolonged chest pain in vasospastic angina

Table 1 Patient characteristics

	Short-duration	Long-duration	P value	Low-frequency	High-frequency	P value
No.	114	53		88	79
Age (yr)	67 ± 10	67 ± 11	0.8401	67 ± 11	68 ± 10	0.6669
Male/female	58/56	28/25	0.8142	40/48	46/33	0.0991
BMI (kg/m2)	24.3 ± 4.1	24.2 ± 3.6	0.7171	24.2 ± 3.8	24.5 ± 4.1	0.5697
Coronary risk factors (%)
Current smoker	24 (21)	9 (17)	0.5385	17 (19)	16 (20)	0.8796
Hypertension	81 (71)	38 (72)	0.9316	64 (73)	55 (70)	0.6578
Dyslipidemia	76 (67)	29 (58)	0.1368	56 (64)	49 (62)	0.8297
Diabetes mellitus	31 (27)	9 (17)	0.1501	19 (19)	23 (29)	0.1386
Alcohol consumption (%)	40 (35)	23 (43)	0.3025	34 (39)	29 (37)	0.7995
Family history of CAD (%)	26 (23)	10 (19)	0.5645	13 (15)	23 (29)	0.0244
CKD (%)	34 (30)	16 (30)	0.9619	21 (24)	29 (37)	0.0704
Taking statins (%)	50 (44)	20 (38)	0.4554	34 (39)	36 (46)	0.3646
LVEF on UCG (%)	66 ± 10	67 ± 9	0.5752	66 ± 9	67 ± 10	0.7165
FMD (%, n)	3.9 ± 3.1 (107)	3.4 ± 3.2 (51)	0.3200	3.9 ± 2.8 (82)	3.5 ± 3.5 (76)	0.4872
NID (%, n)	15.2 ± 7.0 (107)	14.5 ± 6.4 (51)	0.5795	14.8 ± 6.5 (82)	15.1 ± 7.1 (76)	0.8295

BMI: Body mass index; CAD: Coronary artery disease; CKD: Chronic kidney disease; FMD: Flow-mediated dilation; LVEF: Left ventricular ejection fraction; NID: Nitroglycerin-induced dilation; UCG: Cardiac ultrasonography.

Table 2 Vasospastic angina-related symptoms and medications before admission

	Short-duration	Long-duration	P value	Low-frequency	High-frequency	P value
Chest symptoms
Only at rest (%)	88 (77)	48 (91)	0.0814	75 (85)	61 (77)	0.2360
At rest and exercise (%)	12 (11)	1 (2)		4 (5)	9 (11)
Only during exercise (%)	14 (12)	4 (8)		9 (14)	9 (11)
Maximum duration (min)	6 (5, 10)	30 (20, 60)	< 0.0001	10 (6, 20)	10 (5, 10)	0.3633
Frequency (/mo)	4 (2, 12)	4 (2, 10)	0.1833	2 (1, 4)	12 (8, 20)	< 0.0001
Frequency of VA (%)	0 (0)	2 (4)	0.0369	2 (3)	0 (0)	0.1776
Other serious symptoms (%)	3 (3)	13 (25)	< 0.0001	12 (14)	4 (5)	0.0602
No. taking vasodilators before admission	0.5 (0, 1)	0 (0, 1)	0.1786	0 (0, 1)	0 (0, 1)	0.4895

No.: Number; VA: Variant angina.

Table 3 Coronary angiography and spasm provocation test-related parameters

	Short-duration	Long-duration	P value	Low-frequency	High-frequency	P value
CAG
Atherosclerotic change (%)	73 (64)	34 (64)	0.9884	53 (60)	54 (68)	0.7747
Myocardial bridge (%)	11 (11)	5 (9)	0.9646	9 (10)	7 (9)	0.7645
SPT
Low dose of ACh (%)	26 (23)	20 (38)	0.0444	26 (30)	20 (25)	0.5414
Total occlusion (%)	7 (6)	10 (19)	0.0113	6 (7)	11 (14)	0.1295
Multivessel spasm (%)	63 (62)	30 (70)	0.3189	50 (62)	48 (68)	0.4500
(No.)	(n = 102)	(n = 50)		(n = 81)	(n = 71)
Focal/diffuse spasm	12/102	17/36	0.0006	15/73	14/65	0.9083
RCA spasm (%)	78 (68)	39 (74)	0.4977	61 (69)	56 (71)	0.8252
Unavoidable use of NTG (%)	25 (32)	23 (59)	0.0062	20 (34)	28 (49)	0.096
LAD spasm (%)	96 (94)	49 (98)	0.2833	75 (93)	70 (99)	0.0783
(No.)	(n = 102)	(n = 50)		(n = 81)	(n = 71)
Severe complications (%)	7 (6)	5 (9)	0.4430	5 (6)	7 (9)	0.4211

ACh: Acetylcholine; CAG: Coronary angiography; LAD: Left anterior descending coronary artery; No.: Number; NTG: Nitroglycerin; RCA: Right coronary artery; SPT: Spasm provocation test.

Table 4 Vasospastic angina status at follow-up and prognosis

	Short-duration	Long-duration	P value	Low-frequency	High-frequency	P value
No. taking vasodilators at discharge	1 (1, 1)	1 (1, 1)	0.9199	1 (1, 1)	1 (1, 1)	0.7862
Median period of follow-up (mo)	58 (36, 75)	56 (34, 67)	0.3505	54 (20, 75)	59 (41, 71)	0.4678
Follow-up
No. of recent follow-ups (a, %)	82 (71.9)	40 (75.5)	0.7547	60 (68.2)	62 (78.5)	0.2434
No. of deaths during follow-up (b, %)	5 (4.4)	3 (5.6)		4 (4.5)	4 (5.0)
No. of follow-ups before 2018 (c, %)	27 (23.7)	10 (18.9)		24 (27.3)	13 (16.5)
No. of anginal attacks (/mo) in patients (a)	0 (0, 1)	0 (0, 1)	0.4574	0 (0, 1)	0 (0, 2.5)	0.1305
No. taking vasodilators among patients (a)
No. taking vasodilators among patients (a) at follow-up	1 (1, 2)	1 (1, 2)	0.2131	1 (1, 2)	1 (1, 2)	0.7408
Prognosis among patients (a) and (b)
Cardiac death (%)	0 (0)	0 (0)		0 (0)	0 (0)
Noncardiac death (%)	5 (6)	3 (7)	0.7837	4 (6)	4 (6)	0.9642
Cardiac events (%)	13 (15)	4 (9)	0.3695	6 (9)	11 (17)	0.2176

No.: Number; NS: Not significant.