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首页> 外文期刊>Circulation. Arrhythmia and electrophysiology >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.
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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.

机译：在院外心脏骤停中幸存的血管痉挛性心绞痛患者的临床特征和长期预后：日本冠状动脉痉挛协会的多中心注册表研究。

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摘要

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.
机译：背景：冠状动脉痉挛在缺血性心脏病的发病机制中起着重要的作用。然而，其在心源性猝死中的作用尚待充分阐明。我们在日本冠脉痉挛协会的全国多中心注册中心中检查了血管痉挛性心绞痛（VSA）患者的临床特征和结局。方法和结果：在2007年9月至2008年12月之间，共鉴定出1429例VSA患者（男性/女性，1090/339;中位年龄66岁）。他们的特点是吸烟率高，包括35名在院外心脏骤停（OHCA）中幸存的患者。与其余1394名非OHCA患者相比，OHCA幸存者的特征是年龄更年轻（中位年龄分别为58岁和66岁; P <0.001）和左冠状动脉前降支痉挛的发生率较高（72％对53％，P <0.05）。在OHCA幸存者中，有14名患者在接受钙通道阻滞剂的强化治疗的同时接受了植入式心脏复律除颤器（ICD）的植入。与非OHCA患者相比，OHCA幸存者无重大心脏不良事件的生存率显着较低（5年时分别为72％和92％，P <0.001），包括2例因室颤而进行的适当ICD电击。多变量分析显示，OHCA事件与主要不良心脏事件显着相关（危险比为3.25; 95％置信区间为1.39至7.61; P <0.01）。结论：最大的血管痉挛性心绞痛队列研究结果表明，在OHCA中幸存的血管痉挛患者是高危人群。需要进一步的研究以确定植入式心脏复律除颤器疗法是否可以改善患者的预后。

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