Progression and Regression of Coronary Stenosis in the Long-term Follow-up of Vasospastic Angina

Abstract

Background Whether focal vasospasticity plays a pathogenic role in the progression or regression of coronary atherosclerosis is unknown. To determine whether evidence for such a role exists, we studied long-term changes in coronary luminal measurements in patients with vasospastic angina. Methods and Results Quantitative coronary angiography and repeated ergonovine provocation tests were performed 45±16 months apart in 30 patients. All patients had vasospastic anginal symptoms and coronary spasm on the initial provocation test. Of the 30 patients, 16 had persistent symptoms of vasospastic angina and showed coronary spasm at the same site on the follow-up angiogram (group 1), while the remaining 14 whose vasospastic anginal symptoms disappeared at follow-up demonstrated a negative response to ergonovine on the follow-up tests (group 2). There was no significant difference in patients’ baseline characteristics between the two groups. Long-term changes in minimal (MLD) and mean (MEAN) luminal diameter were m...