Document Detail


Clinical characteristics and long-term prognosis of vasospastic angina patients who survived out-of-hospital cardiac arrest: multicenter registry study of the Japanese Coronary Spasm Association.
MedLine Citation:
PMID:  21406685     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Coronary artery spasm plays an important role in the pathogenesis of ischemic heart disease; however, its role in sudden cardiac death remains to be fully elucidated. We examined the clinical characteristics and outcomes of patients with vasospastic angina (VSA) in our nationwide multicenter registry by the Japanese Coronary Spasm Association.
METHODS AND RESULTS: Between September 2007 and December 2008, 1429 patients with VSA (male/female, 1090/339; median, 66 years) were identified. They were characterized by a high prevalence of smoking and included 35 patients who survived out-of-hospital cardiac arrest (OHCA). The OHCA survivors, as compared with the remaining 1394 non-OHCA patients, were characterized by younger age (median, 58 versus 66 years; P<0.001) and higher incidence of left anterior descending coronary artery spasm (72% versus 53%, P<0.05). In the OHCA survivors, 14 patients underwent implantable cardioverter-defibrillator (ICD) implantation while intensively treated with calcium channel blockers. Survival rate free from major adverse cardiac events was significantly lower in the OHCA survivors compared with the non-OHCA patients (72% versus 92% at 5 years, P<0.001), including appropriate ICD shocks for ventricular fibrillation in 2 patients. Multivariable analysis revealed that OHCA events were significantly correlated with major adverse cardiac events (hazard ratio, 3.25; 95% confidence interval, 1.39 to 7.61; P<0.01).
CONCLUSIONS: These results from the largest vasospastic angina cohort indicate that vasospasm patients who survived OHCA are high-risk population. Further studies are needed to determine whether implantable cardioverter-defibrillator therapy improves patient prognosis.
Authors:
Yusuke Takagi; Satoshi Yasuda; Ryusuke Tsunoda; Yasuhiro Ogata; Atsushi Seki; Tetsuya Sumiyoshi; Motoyuki Matsui; Toshikazu Goto; Yasuhiko Tanabe; Shozo Sueda; Toshiaki Sato; Satoshi Ogawa; Norifumi Kubo; Shin-ichi Momomura; Hisao Ogawa; Hiroaki Shimokawa;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2011-03-15
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  4     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-15     Completed Date:  2011-09-01     Revised Date:  2012-02-03    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  295-302     Citation Subset:  IM    
Affiliation:
Tohoku University Graduate School of Medicine, Sendai, Japan.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiology
Coronary Vasospasm / epidemiology*,  etiology,  physiopathology
Female
Follow-Up Studies
Humans
Incidence
Japan / epidemiology
Male
Middle Aged
Out-of-Hospital Cardiac Arrest / complications*,  epidemiology
Prognosis
Registries*
Retrospective Studies
Societies, Medical / statistics & numerical data*
Survivors / statistics & numerical data*
Time Factors
Investigator
Investigator/Affiliation:
Hironori Murakami / ; Takashi Takenaka / ; Kunihiko Hirasawa / ; Motoyuki Nakamura / ; Isao Kubota / ; Toshikazu Goto / ; Hiroaki Shimokawa / ; Yasuchika Takeishi / ; Toshio Nishikimi / ; Shin-ichi Momomura / ; Makoto Suzuki / ; Osamu Ueda / ; Michihiro Yoshimura / ; Tetsuya Sumiyoshi / ; Satoshi Ogawa / ; Yuji Ikari / ; Kazuo Kimura / ; Youichi Takeyama / ; Hirofumi Kambara / ; Yoshifusa Aizawa / ; Yasuhiko Tanabe / ; Shinya Minatoguchi / ; Masaaki Takahashi / ; Hiroshi Inoue / ; Masakazu Yamagishi / ; Minoru Horie / ; Masaaki Ito / ; Akira Itoh / ; Seinosuke Kawashima / ; Syunichi Miyazaki / ; Yoshihiko Saito / ; Manabu Shirotani / ; Takashi Akasaka / ; Yasuki Kihara / ; Masunori Matsuzaki / ; Jitsuo Higaki / ; Shozo Sueda / ; Yoshikazu Hiasa / ; Hidenori Urata / ; Natsuki Nakamura / ; Koichi Node / ; Hisao Ogawa / ; Koichi Nakao / ; Yasuhiro Ogata / ; Chuwa Tei / ; Kazuhiko Nakamura / ; Michio Shimabukuro /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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