Provoked Coronary Spasm Predicts Adverse Outcome in Patients With Acute Myocardial InfarctionA Novel Predictor of Prognosis After Acute Myocardial Infarction
Kohei Wakabayashi, MD, PhD*,
Hiroshi Suzuki, MD, PhD*,*,
Yuki Honda, MD*,
Daisuke Wakatsuki, MD*,
Keisuke Kawachi, MD*,
Kei Ota, MD*,
Shinji Koba, MD, PhD ,
Nobuyuki Shimizu, MD, PhD*,
Fuyuki Asano, MD, PhD*,
Tokutada Sato, MD, PhD* and
Youichi Takeyama, MD, PhD*
* Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan
Third Department of Internal Medicine, Showa University, School of Medicine, Tokyo, Japan.
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Figure 1 Kaplan-Meier Curves for MACE-Free Survival
Kaplan-Meier curves for MACE-free survival in the positive and negative groups. The frequency of MACE-free survival was significantly lower in the positive group than in the negative group (p = 0.0018). ACh = acetylcholine; MACE = major adverse cardiac events.
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Figure 2 Relationship Between the Spasm-Positive Artery and the Advance of Coronary Lesions
Target vessel revascularization was more frequent in the spasm-positive arteries (PAs) (31.7%) than in the spasm-negative arteries (NAs) (18.2%, p = 0.014). De novo lesions, including acute coronary syndrome lesions, were observed in 25 of 400 PAs and in 3 NAs (p = 0.00044). Acute coronary syndrome (ACS) was observed in 10 of 400 PAs and in 0 of 301 NAs (p = 0.0057).
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