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Erschienen in: Heart and Vessels 8/2020

09.03.2020 | Original Article

Clinical impact of statin therapy on vasospastic angina: data from a Korea nation-wide cohort study

verfasst von: Won-Woo Seo, Sang-Ho Jo, Sung Eun Kim, Seung Hwan Han, Kwan Yong Lee, Sung Ho Her, Min-Ho Lee, Sung Seek Cho, Sang Hong Baek

Erschienen in: Heart and Vessels | Ausgabe 8/2020

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Abstract

The effect of statin therapy on reducing adverse cardiovascular events in vasospastic angina (VSA) has been inconsistent. Therefore, we investigated the association between statin therapy and adverse cardiovascular events in a large, prospective VSA cohort. The Variant Angina Korea registry consecutively enrolled 2960 patients suspected VSA. Among them, we included 1713 patients who were diagnosed with VSA based on coronary provocation test. We divided the patients into the statin (n = 744) and no-statin group (n = 914) according to the medication prescribed at discharge. The primary outcome was a composite of cardiac death, acute coronary syndrome, and new-onset life-threatening arrhythmia during a 3-year follow-up period. The primary outcome occurred in 32 patients (4.3%) in the statin and 28 patients (3.1%) in the no-statin group. In Kaplan–Meier analysis before and after propensity score matching, there was no significant difference in the cumulative incidence of primary outcomes between both groups. Multivariate Cox regression analysis demonstrated that the focal type of VSA was independent predictor of primary outcomes, but statin therapy was not. Furthermore, the lack of benefit of statin therapy for primary outcomes was consistently observed across the statin intensity and spasm characteristics. In conclusion, the present study demonstrated that statin therapy did not reduce adverse cardiovascular events in patients with VSA.
Literatur
1.
Zurück zum Zitat Beltrame JF, Sasayama S, Maseri A (1999) Racial heterogeneity in coronary artery vasomotor reactivity: differences between Japanese and Caucasian patients. J Am Coll Cardiol 33:1442–1452CrossRef Beltrame JF, Sasayama S, Maseri A (1999) Racial heterogeneity in coronary artery vasomotor reactivity: differences between Japanese and Caucasian patients. J Am Coll Cardiol 33:1442–1452CrossRef
2.
Zurück zum Zitat JCS Joint Working Group (2014) Guidelines for diagnosis and treatment of patients with vasospastic angina (coronary spastic angina) (JCS 2013). Circ J 78:2779–2801CrossRef JCS Joint Working Group (2014) Guidelines for diagnosis and treatment of patients with vasospastic angina (coronary spastic angina) (JCS 2013). Circ J 78:2779–2801CrossRef
3.
Zurück zum Zitat Yamagishi M, Miyatake K, Tamai J, Nakatani S, Koyama J, Nissen SE (1994) Intravascular ultrasound detection of atherosclerosis at the site of focal vasospasm in angiographically normal or minimally narrowed coronary segments. J Am Coll Cardiol 23:352–357CrossRef Yamagishi M, Miyatake K, Tamai J, Nakatani S, Koyama J, Nissen SE (1994) Intravascular ultrasound detection of atherosclerosis at the site of focal vasospasm in angiographically normal or minimally narrowed coronary segments. J Am Coll Cardiol 23:352–357CrossRef
4.
Zurück zum Zitat Sakamoto K, Nagamatsu S, Yamamoto E, Kaikita K, Tsujita K (2018) Atherosclerotic coronary plaque development visualized by in vivo coronary imaging. Circ J 82:1727–1734CrossRef Sakamoto K, Nagamatsu S, Yamamoto E, Kaikita K, Tsujita K (2018) Atherosclerotic coronary plaque development visualized by in vivo coronary imaging. Circ J 82:1727–1734CrossRef
5.
Zurück zum Zitat Teragawa H, Masaya K, Kurokawa J, Yamagata T, Matsuura H, Chayama K (2001) Endothelial dysfunction is an independent factor responsible for vasospastic angina. Clin Sci 101:707–713CrossRef Teragawa H, Masaya K, Kurokawa J, Yamagata T, Matsuura H, Chayama K (2001) Endothelial dysfunction is an independent factor responsible for vasospastic angina. Clin Sci 101:707–713CrossRef
7.
Zurück zum Zitat Jung KY, Kim KM, Han SK, Yun HM, Oh TJ, Choi SH, Park KS, Jang HC, Lim S (2018) Effect of rosuvastatin on cholesterol efflux capacity and endothelial function in type 2 diabetes mellitus and dyslipidemia. Circ J 82:1387–1395CrossRef Jung KY, Kim KM, Han SK, Yun HM, Oh TJ, Choi SH, Park KS, Jang HC, Lim S (2018) Effect of rosuvastatin on cholesterol efflux capacity and endothelial function in type 2 diabetes mellitus and dyslipidemia. Circ J 82:1387–1395CrossRef
8.
Zurück zum Zitat Kim KH, Cho SH, Yim YR, Lee KJ, Yum JH, Yoon HJ, Yoon NS, Hong YJ, Park HW, Kim JH (2013) Effects of low dose versus high dose statin therapy on the changes of endothelial function and carotid intima-media thickness in patients with variant angina. J Cardiovasc Ultrasound 21:58–63CrossRef Kim KH, Cho SH, Yim YR, Lee KJ, Yum JH, Yoon HJ, Yoon NS, Hong YJ, Park HW, Kim JH (2013) Effects of low dose versus high dose statin therapy on the changes of endothelial function and carotid intima-media thickness in patients with variant angina. J Cardiovasc Ultrasound 21:58–63CrossRef
9.
Zurück zum Zitat Yun KH, Shin I-S, Park EM, Rhee SJ, Lee EM, Yoo NJ, Kim N-H, Oh SK, Jeong J-W (2008) Effect of additional statin therapy on endothelial function and prognosis in patients with vasospastic angina. Korean Circ J 38:638–643CrossRef Yun KH, Shin I-S, Park EM, Rhee SJ, Lee EM, Yoo NJ, Kim N-H, Oh SK, Jeong J-W (2008) Effect of additional statin therapy on endothelial function and prognosis in patients with vasospastic angina. Korean Circ J 38:638–643CrossRef
10.
Zurück zum Zitat Yasue H, Mizuno Y, Harada E, Itoh T, Nakagawa H, Nakayama M, Ogawa H, Tayama S, Honda T, Hokimoto S (2008) Effects of a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, fluvastatin, on coronary spasm after withdrawal of calcium-channel blockers. J Am Coll Cardiol 51:1742–1748CrossRef Yasue H, Mizuno Y, Harada E, Itoh T, Nakagawa H, Nakayama M, Ogawa H, Tayama S, Honda T, Hokimoto S (2008) Effects of a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, fluvastatin, on coronary spasm after withdrawal of calcium-channel blockers. J Am Coll Cardiol 51:1742–1748CrossRef
11.
Zurück zum Zitat Ishii M, Kaikita K, Sato K, Yamanaga K, Miyazaki T, Akasaka T, Tabata N, Arima Y, Sueta D, Sakamoto K (2016) Impact of statin therapy on clinical outcome in patients with coronary spasm. J Am Heart Assoc 5:e003426CrossRef Ishii M, Kaikita K, Sato K, Yamanaga K, Miyazaki T, Akasaka T, Tabata N, Arima Y, Sueta D, Sakamoto K (2016) Impact of statin therapy on clinical outcome in patients with coronary spasm. J Am Heart Assoc 5:e003426CrossRef
12.
Zurück zum Zitat Oh MS, Yang JH, Park TK, Song YB, Hahn JY, Choi JH, Lee SH, Gwon HC, Choi SH (2016) Impact of statin therapy on long-term clinical outcomes of vasospastic angina without significant stenosis: a propensity-score matched analysis. Int J Cardiol 223:791–796CrossRef Oh MS, Yang JH, Park TK, Song YB, Hahn JY, Choi JH, Lee SH, Gwon HC, Choi SH (2016) Impact of statin therapy on long-term clinical outcomes of vasospastic angina without significant stenosis: a propensity-score matched analysis. Int J Cardiol 223:791–796CrossRef
13.
Zurück zum Zitat Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, Hoes AW, Jennings CS, Landmesser U, Pedersen TR (2016) 2016 ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J 37:2999–3058CrossRef Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, Hoes AW, Jennings CS, Landmesser U, Pedersen TR (2016) 2016 ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J 37:2999–3058CrossRef
14.
Zurück zum Zitat Nagar SP, Rane PP, Fox KM, Meyers J, Davis K, Beaubrun A, Inomata H, Qian Y, Kajinami K (2018) Treatment patterns, statin intolerance, and subsequent cardiovascular events among Japanese patients with high cardiovascular risk initiating statin therapy. Circ J 82:1008–1016CrossRef Nagar SP, Rane PP, Fox KM, Meyers J, Davis K, Beaubrun A, Inomata H, Qian Y, Kajinami K (2018) Treatment patterns, statin intolerance, and subsequent cardiovascular events among Japanese patients with high cardiovascular risk initiating statin therapy. Circ J 82:1008–1016CrossRef
15.
Zurück zum Zitat Shin DI, Baek SH, Her SH, Han SH, Ahn Y, Park K-H, Kim D-S, Yang T-H, Choi D-J, Suh J-W (2015) The 24-month prognosis of patients with positive or intermediate results in the intracoronary ergonovine provocation test. JACC Cardiovasc Interv 8:914–923CrossRef Shin DI, Baek SH, Her SH, Han SH, Ahn Y, Park K-H, Kim D-S, Yang T-H, Choi D-J, Suh J-W (2015) The 24-month prognosis of patients with positive or intermediate results in the intracoronary ergonovine provocation test. JACC Cardiovasc Interv 8:914–923CrossRef
16.
Zurück zum Zitat Yamagishi M, Ito K, Tsutsui H, Miyazaki S, Goto Y, Nagaya N, Sumiyoshi T, Fukami K, Haze K, Kitakaze M (2003) Lesion severity and hypercholesterolemia determine long-term prognosis of vasospastic angina treated with calcium channel antagonists. Circ J 67:1029–1035CrossRef Yamagishi M, Ito K, Tsutsui H, Miyazaki S, Goto Y, Nagaya N, Sumiyoshi T, Fukami K, Haze K, Kitakaze M (2003) Lesion severity and hypercholesterolemia determine long-term prognosis of vasospastic angina treated with calcium channel antagonists. Circ J 67:1029–1035CrossRef
17.
Zurück zum Zitat Kim D-W, Her S-H, Ahn Y, Shin DI, Han SH, Kim D-S, Choi D-J, Kwon HM, Gwon H-C, Jo S-H (2018) Clinical outcome according to spasm type of single coronary artery provoked by intracoronary ergonovine tests in patients without significant organic stenosis. Int J Cardiol 252:6–12CrossRef Kim D-W, Her S-H, Ahn Y, Shin DI, Han SH, Kim D-S, Choi D-J, Kwon HM, Gwon H-C, Jo S-H (2018) Clinical outcome according to spasm type of single coronary artery provoked by intracoronary ergonovine tests in patients without significant organic stenosis. Int J Cardiol 252:6–12CrossRef
18.
Zurück zum Zitat Davignon J, Ganz P (2004) Role of endothelial dysfunction in atherosclerosis. Circulation 109:III27–III32PubMed Davignon J, Ganz P (2004) Role of endothelial dysfunction in atherosclerosis. Circulation 109:III27–III32PubMed
19.
Zurück zum Zitat Kugiyama K, Yasue H, Okumura K, Ogawa H, Fujimoto K, Nakao K, Yoshimura M, Motoyama T, Inobe Y, Kawano H (1996) Nitric oxide activity is deficient in spasm arteries of patients with coronary spastic angina. Circulation 94:266–272CrossRef Kugiyama K, Yasue H, Okumura K, Ogawa H, Fujimoto K, Nakao K, Yoshimura M, Motoyama T, Inobe Y, Kawano H (1996) Nitric oxide activity is deficient in spasm arteries of patients with coronary spastic angina. Circulation 94:266–272CrossRef
20.
Zurück zum Zitat Okumura K, Yasue H, Matsuyama K, Ogawa H, Kugiyama K, Ishizaka H, Sumida H, Fujii H, Matsunaga T, Tsunoda R (1996) Diffuse disorder of coronary artery vasomotility in patients with coronary spastic angina: hyperreactivity to the constrictor effects of acetylcholine and the dilator effects of nitroglycerin. J Am Coll Cardiol 27:45–52CrossRef Okumura K, Yasue H, Matsuyama K, Ogawa H, Kugiyama K, Ishizaka H, Sumida H, Fujii H, Matsunaga T, Tsunoda R (1996) Diffuse disorder of coronary artery vasomotility in patients with coronary spastic angina: hyperreactivity to the constrictor effects of acetylcholine and the dilator effects of nitroglycerin. J Am Coll Cardiol 27:45–52CrossRef
21.
Zurück zum Zitat Furchgott RF, Zawadzki JV (1980) The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature 288:373CrossRef Furchgott RF, Zawadzki JV (1980) The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature 288:373CrossRef
22.
Zurück zum Zitat Laufs U, La Fata V, Plutzky J, Liao JK (1998) Upregulation of endothelial nitric oxide synthase by HMG CoA reductase inhibitors. Circulation 97:1129–1135CrossRef Laufs U, La Fata V, Plutzky J, Liao JK (1998) Upregulation of endothelial nitric oxide synthase by HMG CoA reductase inhibitors. Circulation 97:1129–1135CrossRef
23.
Zurück zum Zitat Tamai O, Matsuoka H, Itabe H, Wada Y, Kohno K, Imaizumi T (1997) Single LDL apheresis improves endothelium-dependent vasodilatation in hypercholesterolemic humans. Circulation 95:76–82CrossRef Tamai O, Matsuoka H, Itabe H, Wada Y, Kohno K, Imaizumi T (1997) Single LDL apheresis improves endothelium-dependent vasodilatation in hypercholesterolemic humans. Circulation 95:76–82CrossRef
24.
Zurück zum Zitat Igarashi K, Tsuji M, Nishimura M, Horimoto M (2004) Improvement of endothelium-dependent coronary vasodilation after a single LDL apheresis in patients with hypercholesterolemia. J Clin Aphe 19:11–16CrossRef Igarashi K, Tsuji M, Nishimura M, Horimoto M (2004) Improvement of endothelium-dependent coronary vasodilation after a single LDL apheresis in patients with hypercholesterolemia. J Clin Aphe 19:11–16CrossRef
25.
Zurück zum Zitat Ishii M, Kaikita K, Sato K, Tanaka T, Sugamura K, Sakamoto K, Izumiya Y, Yamamoto E, Tsujita K, Yamamuro M (2015) Acetylcholine-provoked coronary spasm at site of significant organic stenosis predicts poor prognosis in patients with coronary vasospastic angina. J Am Coll Cardiol 66:1105–1115CrossRef Ishii M, Kaikita K, Sato K, Tanaka T, Sugamura K, Sakamoto K, Izumiya Y, Yamamoto E, Tsujita K, Yamamuro M (2015) Acetylcholine-provoked coronary spasm at site of significant organic stenosis predicts poor prognosis in patients with coronary vasospastic angina. J Am Coll Cardiol 66:1105–1115CrossRef
26.
Zurück zum Zitat Park SJ, Park H, Kang D, Park TK, Park J, Cho J, Chung CR, Jeon K, Guallar E, Cho J (2019) Association of statin therapy with clinical outcomes in patients with vasospastic angina: data from Korean health insurance review and assessment service. PLoS ONE 14:e0210498CrossRef Park SJ, Park H, Kang D, Park TK, Park J, Cho J, Chung CR, Jeon K, Guallar E, Cho J (2019) Association of statin therapy with clinical outcomes in patients with vasospastic angina: data from Korean health insurance review and assessment service. PLoS ONE 14:e0210498CrossRef
27.
Zurück zum Zitat Ginsburg R, Lamb IH, Schroeder JS, Hu M, Harrison DC (1982) Randomized double-blind comparison of nifedipine and isosorbide dinitrate therapy in variant angina pectoris due to coronary artery spasm. Am Heart J 103:44–48CrossRef Ginsburg R, Lamb IH, Schroeder JS, Hu M, Harrison DC (1982) Randomized double-blind comparison of nifedipine and isosorbide dinitrate therapy in variant angina pectoris due to coronary artery spasm. Am Heart J 103:44–48CrossRef
28.
Zurück zum Zitat Nishigaki K, Inoue Y, Yamanouchi Y, Fukumoto Y, Yasuda S, Sueda S, Urata H, Shimokawa H, Minatoguchi S (2010) Prognostic effects of calcium channel blockers in patients with vasospastic angina. Circ J 74:1943–1950CrossRef Nishigaki K, Inoue Y, Yamanouchi Y, Fukumoto Y, Yasuda S, Sueda S, Urata H, Shimokawa H, Minatoguchi S (2010) Prognostic effects of calcium channel blockers in patients with vasospastic angina. Circ J 74:1943–1950CrossRef
29.
Zurück zum Zitat Beltrame JF, Crea F, Kaski JC, Ogawa H, Ong P, Sechtem U, Shimokawa H, Merz CNB, Group CVDIS (2015) The who, what, why, when, how and where of vasospastic angina. Circ J 80:289–298CrossRef Beltrame JF, Crea F, Kaski JC, Ogawa H, Ong P, Sechtem U, Shimokawa H, Merz CNB, Group CVDIS (2015) The who, what, why, when, how and where of vasospastic angina. Circ J 80:289–298CrossRef
30.
Zurück zum Zitat Mason RP, Kubant R, Heeba G, Jacob RF, Day CA, Medlin YS, Funovics P, Malinski T (2008) Synergistic effect of amlodipine and atorvastatin in reversing LDL-induced endothelial dysfunction. Pharm Res 25:1798–1806CrossRef Mason RP, Kubant R, Heeba G, Jacob RF, Day CA, Medlin YS, Funovics P, Malinski T (2008) Synergistic effect of amlodipine and atorvastatin in reversing LDL-induced endothelial dysfunction. Pharm Res 25:1798–1806CrossRef
31.
Zurück zum Zitat Han SH, Lee KY, Her SH, Ahn Y, Park K-H, Kim D-S, Yang T-H, Choi D-J, Suh J-W, Kwon HM (2019) Impact of multi-vessel vasospastic angina on cardiovascular outcome. Atherosclerosis 281:107–113CrossRef Han SH, Lee KY, Her SH, Ahn Y, Park K-H, Kim D-S, Yang T-H, Choi D-J, Suh J-W, Kwon HM (2019) Impact of multi-vessel vasospastic angina on cardiovascular outcome. Atherosclerosis 281:107–113CrossRef
32.
Zurück zum Zitat Hwang D, Kim HK, Lee JM, Choi KH, Kim J, Rhee T-M, Park J, Park TK, Yang JH, Song YB (2018) Effects of statin intensity on clinical outcome in acute myocardial infarction patients. Circ J 82:1112–1120CrossRef Hwang D, Kim HK, Lee JM, Choi KH, Kim J, Rhee T-M, Park J, Park TK, Yang JH, Song YB (2018) Effects of statin intensity on clinical outcome in acute myocardial infarction patients. Circ J 82:1112–1120CrossRef
Metadaten
Titel
Clinical impact of statin therapy on vasospastic angina: data from a Korea nation-wide cohort study
verfasst von
Won-Woo Seo
Sang-Ho Jo
Sung Eun Kim
Seung Hwan Han
Kwan Yong Lee
Sung Ho Her
Min-Ho Lee
Sung Seek Cho
Sang Hong Baek
Publikationsdatum
09.03.2020
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 8/2020
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-020-01579-z

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