Takatsu Fumimaro, Watarai Masato
Department of Cardiology, Anjo Kosei Hospital, Aichi, Japan.
Coron Artery Dis. 2011 Jan;22(1):1-5. doi: 10.1097/MCA.0b013e3283402313.
Several studies have shown that significant coronary narrowing makes the prognosis of vasospastic angina pectoris (VAP) worse. However, the effects of various factors on the prognosis of patients without significant arterial narrowing have not yet been shown.
We investigated 1248 consecutive patients with VAP who had no coronary stenosis of more than or equal to 50%. The mean follow-up was 11.7±6.8 years. Ninety-one patients (7.3%) developed unstable angina, acute myocardial infarction, or effort angina with new coronary narrowings. Thirty patients (2.4%) died suddenly. Multivariate analysis showed that the presence of coronary stenosis, even if trivial, made the prognosis worse (P=0.027; odds ratio, 1.66; 95% confidence interval, 1.06-2.61). In addition, unusually, female patients had a better prognosis than male patients (P=0.007; odds ratio, 0.35; 95% confidence interval, 0.16-0.75). Other factors, such as hyperlipemia, diabetes, and hypertension did not affect the prognosis.
In patients with VAP, the presence of coronary narrowing, even if mild, was associated with worse prognosis.
多项研究表明，显著的冠状动脉狭窄会使变异性心绞痛（VAP）的预后变差。然而，各种因素对无显著动脉狭窄患者预后的影响尚未明确。
我们对1248例连续的无冠状动脉狭窄≥50%的VAP患者进行了调查。平均随访时间为11.7±6.8年。91例患者（7.3%）发生了不稳定型心绞痛、急性心肌梗死或伴有新的冠状动脉狭窄的劳力性心绞痛。30例患者（2.4%）猝死。多因素分析显示，即使冠状动脉狭窄程度轻微，也会使预后变差（P = 0.027；比值比，1.66；95%置信区间，1.06 - 2.61）。此外，不同寻常的是，女性患者的预后优于男性患者（P = 0.007；比值比，0.35；95%置信区间，0.16 - 0.75）。其他因素，如高脂血症、糖尿病和高血压，并不影响预后。
在VAP患者中，即使冠状动脉狭窄程度较轻，也与较差的预后相关。
