Tashiro H, Shimokawa H, Koyanagi S, Takeshita A
Research Institute of Angiocardiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Jpn Circ J. 1993 Feb;57(2):117-22. doi: 10.1253/jcj.57.117.
To determine the factors influencing the spontaneous remission of variant angina, clinical characteristics were examined in 75 Japanese patients with variant angina. Spontaneous remission was defined as an absence of angina at rest for at least 3 months after withdrawal of treatment with calcium antagonists. This remission occurred in 12 patients (16%) (remission group), while angina persisted despite treatment with calcium antagonists and nitrates in 33 patients (44%) (persistent angina group). The remaining 30 patients (40%) were angina-free under treatment with calcium antagonists and/or nitrates (angina-free on treatment group). The prevalence of significant coronary artery stenosis (> 75%) was significantly higher in the remission group than in the persistent angina group (44% vs 7%, p < 0.05). The prevalence of cessation of smoking was significantly higher in the remission group than in the persistent angina group (92% vs 39%, p < 0.01). Age, gender, other coronary risk factors, disease activity of variant angina and site of myocardial ischemia during anginal attacks were not statistically different among the 3 groups. There data indicate that remission of variant angina occurs more frequently in patients with than in those without significant coronary artery stenosis and that cessation of smoking is an important factor for remission of variant angina.
为了确定影响变异型心绞痛自发缓解的因素,我们对75例日本变异型心绞痛患者的临床特征进行了检查。自发缓解定义为停用钙拮抗剂治疗后至少3个月静息时无心绞痛发作。12例患者(16%)出现了这种缓解(缓解组),而33例患者(44%)尽管接受了钙拮抗剂和硝酸盐治疗,心绞痛仍持续存在(持续性心绞痛组)。其余30例患者(40%)在接受钙拮抗剂和/或硝酸盐治疗时无心绞痛发作(治疗期间无心绞痛组)。缓解组中严重冠状动脉狭窄(>75%)的患病率显著高于持续性心绞痛组(44%对7%,p<0.05)。缓解组中戒烟的患病率显著高于持续性心绞痛组(92%对39%,p<0.01)。年龄、性别、其他冠状动脉危险因素、变异型心绞痛的疾病活动度以及心绞痛发作时心肌缺血的部位在三组之间无统计学差异。这些数据表明,有严重冠状动脉狭窄的变异型心绞痛患者比无严重冠状动脉狭窄的患者更易出现自发缓解,且戒烟是变异型心绞痛缓解的一个重要因素。