Skip to main content
SpringerLink
Log in

The real world in the clinic before and after the establishment of guidelines for coronary artery spasm: a questionnaire for members of the Japanese Cine-angio Association

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

We investigated the clinical situations and the present knowledge of Japanese cardiologists about coronary artery spasm before and after the establishment of guidelines for this condition in the real world. A questionnaire was developed regarding the number of cases of coronary angiography, percutaneous coronary intervention, and invasive/non-invasive spasm provocation tests before (2008) and after (2014) the establishment of the Japanese Circulation Society (JCS) guidelines for coronary artery spasm and the status of spasm provocation tests. The questionnaire was sent to members of the Japanese Cine-angio Association in 81 cardiology hospitals in Japan. The completed surveys were returned from 20 hospitals, giving a response rate of 24.7%. Pharmacological spasm provocation tests increased in 2014 and vasospastic angina and variant angina also increased in 2014 compared with 2008, but the increase was not significant. Non-invasive spasm provocation tests such as hyperventilation tests and cold stress tests decreased remarkably in 2014. Spasm provocation tests were initially performed in the left coronary artery was employed in just 30% of the hospitals. The majority of institutions did not perform the spasm provocation testing in patients with unknown causes of heart failure or in survivors of ventricular fibrillation. Although 40% of the hospitals were not satisfied with standard spasm provocation tests, the majority of the hospitals agreed that spasm provocation tests will be necessary in the future. In general, the JCS guidelines contributed to the widespread use of provocative testing for coronary artery spasm in the real world. However, some issues about spasm still remained in the clinic.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. JCS Joint Working Group (2010) Guidelines for diagnosis and treatment of patients with vasospastic angina (coronary spastic angina) (JCS 2008). Circ J 74:1745–1762

    Article  Google Scholar 

  2. Sueda S, Izoe Y, Kohno H, Fukuda H, Uraoka T (2005) Need for documentation of guidelines for coronary artery spasm: an investigation by questionnaire in Japan. Circ J 69:1333–1337

    Article  PubMed  Google Scholar 

  3. Sueda S, Oshita A, Izoe Y, Johno H, Fukuda H (2006) Potential risk by the lack of recognition of coronary spasm: analysis of the coronary spasm questionnaire in Japan. J Cardiol 49:83–90 (in Japanese)

    Google Scholar 

  4. Sueda S, Oshita A, Izoe Y, Kohno H, Fukuda H (2006) Survey of coronary spasm in Japan before the establishment of spasm guideline: analysis of questionnaire in all Japan. J Cardiol 48:333–343 (in Japanese)

    PubMed  Google Scholar 

  5. Sueda S, Kohno H (2004) An investigation on the coronary spasm by questionnaire: the real world of coronary spasm provocation test and the present knowledge of coronary spasm in Japan. J Jpn Coron Assoc 10:182–188 (in Japanese)

    Google Scholar 

  6. Sueda S, Izoe Y, Kohno H, Fukuda H (2006) What is the standard for cardiology management in Japan?: from analysis of a questionnaire. Jpn J Interv Cardiol 21:47–54 (in Japanese)

    Google Scholar 

  7. Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj S (2013) 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the Management of Stable Coronary Artery Disease of the European Society of Cardiology [published correction appears in Eur Heart J 2014; 35: 2260–2261]. Eur Heart J 34:2949–3003

    Article  PubMed  Google Scholar 

  8. Anderson JI, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr (2013) 2012 ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines [published correction appears in Circulation. 2013; 127: e863–e864]. Circulation 127:e663–e828

    Article  PubMed  Google Scholar 

  9. Sueda S, Kohno H, Fukuda H, Ochi N, Kawada H, Hayashi Y, Uraoka T (2003) Induction of coronary artery response by two pharmacological agents: comparison between intracoronary injection of acetylcholine and ergonovine. Coron Artery Dis 14:451–457

    Article  PubMed  Google Scholar 

  10. JCS Joint Working Group (2014) Guidelines for diagnosis and treatment of patients with vasospastic angina (coronary spastic angina) (JCS 2013). Circ J 78:2779–2801

    Article  Google Scholar 

  11. Okumura K, Yasue H, Matsuyama K, Goto K, Miyagi H, Ogawa H, Matsuyama K (1988) Sensitivity and specificity of intracoronary injection of acetylcholine for the induction of coronary artery spasm. J Am Coll Cardiol 12:883–888

    Article  CAS  PubMed  Google Scholar 

  12. Okumura K, Yasue H, Horio Y, Takaoka K, Matsuyama K, Kugiyama K, Fujii H, Morikami Y (1988) Multivessel coronary spasm in patients with variant angina: a study with intracoronary injection of acetylcholine. Circulation 77:535–542

    Article  CAS  PubMed  Google Scholar 

  13. Sueda S, Kohno H, Oshita A, Izoe Y, Nomoto T, Fukuda H (2009) Vasospastic heart failure: multiple spasm may cause transient heart failure? J Cardiol 54:452–459

    Article  PubMed  Google Scholar 

  14. Inami T, Kataoka M, Shimura N, Ishiguro H, Kohshoh H, Taguchi H, Yanagisawa R, Hara Y, Satoh T, Yoshino H (2012) Left ventricular dysfunction due to diffuse multiple vessel coronary artery spasm can be concealed in dilated cardiomyopathy. Eur J Heart Failure 14:1130–1138

    Article  CAS  Google Scholar 

  15. Takagi Y, Yasuda S, Takahashi J, Takeda M, Nakayama M, Ito K, Hirose M, Wakayama Y, Shimokawa H (2009) Impact of dual induction tests for coronary vasospasm and ventricular fibrillation in patients surviving out-of-hospital cardiac arrest. Cir J 73:767–769

    Article  Google Scholar 

  16. Sueda S, Kohno H (2009) Dual induction tests save patients surviving out-of-hospital cardiac arrest—the revival of coronary spasm. Circ J 73:630–631

    Article  PubMed  Google Scholar 

  17. Sueda S, Miyoshi T, Sasaki Y, Sakaue T, Habara H, Kohno H (2016) Safety and optimal protocol of provocation test for diagnosis of multivessel spasm. Heart Vessels 31:137–142

    Article  PubMed  Google Scholar 

  18. Sueda S, Kohno H, Miyoshi T, Sakaue T, Sasaki Y, Habara H (2015) Maximal acetylcholine dose of 200 μg into the left coronary artery as a spasm provocation test: comparison with 100 μg of acetylcholine. Heart Vessels 30:771–778

    Article  PubMed  Google Scholar 

  19. Sueda S, Mineoi K, Kondo T, Yano K, Ochi T, Ochi N, Fukuda H, Kukita H, Kawada H, Matsuda S, Uraoka T (1998) Absence of induced spasm by intracoronary injection of 50 μg acetylcholine in the right coronary artery: usefulness of 80 μg of acetylcholine as a spasm provocation test. J Cardiol 32:155–161 (in Japanese)

    CAS  PubMed  Google Scholar 

  20. Beltrame JF, Crea F, Kaski JC, Ogawa H, Ong P, Sechtem U, Shimokawa H, Merz NB, On behalf of the Coronary Vasomotion Disorders International Study Group (COVADIS) (2016) The who, what, why, when, how and where of vasospastic angina. Circ J 80:289–298

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, Ehime Prefectural Niihama Hospital, Hongou 3 Choume 1-1, Niihama City, Ehime, 792-0042, Japan

    Shozo Sueda

  2. Department of Cardiology, Tsukazaki Hospital, Himeji, Japan

    Hiroaki Kohno

  3. Department of Cardiology, Kyorin University Hospital, Tokyo, Japan

    Hideaki Yoshino

Authors
  1. Shozo Sueda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroaki Kohno
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hideaki Yoshino
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shozo Sueda.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest.

Appendix

Appendix

We thank the following for the cooperation.

Odawara Cardiovascular Hospital (Kunio Ebine Dr.), Tsukuba Memorial Hospital, Tsukuba Heart Center (Kenji Wagatsuma Dr.), Cardiovascular Division, Osaka National Hospital (Yasunori Ueda Dr.), Joetsu General Hospital (Mitsuru Kagoshima Dr.), The Cardiovascular Institute (Junji Yajima Dr.), Kawachi General Hospital (Masayoshi Mishima Dr.), Tokyo Medical University Hachioji Medical Center (Nobuhiro Tanaka Dr.), Nihon University Itabashi Hospital (Tadateru Takayama Dr.), National Hospital Organizing Saitama National Hospital (Masahiro Suzuki Dr.), Sakakibara Heart Insitute (Atsushi Seki Dr.), St. Marianna University School of Medicine (Yasuhiro Tanabe Dr.), Imus Katsushika Heart Center (Masayoshi Sakakibara Dr.), Disaster Medical Center (Masakazu Ohno Dr. and Yasuhiro Satoh Dr.), Tsuruoka Kyouritsu Hospital (Seiichi Ichikawa Dr.), Kumamoto Chuo Hospital (Shuichi Oshima Dr.), Nayoro City General Hospital (Masaru Yamaki Dr., Kazuma Izawa Dr.), Nippon Medical School Musashi-kosugi Hospital (Koji Takagi Dr.), Musashino Red Cross Hospital (Takamichi Miyamoto Dr.).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sueda, S., Kohno, H. & Yoshino, H. The real world in the clinic before and after the establishment of guidelines for coronary artery spasm: a questionnaire for members of the Japanese Cine-angio Association. Heart Vessels 32, 637–643 (2017). https://doi.org/10.1007/s00380-016-0916-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-016-0916-9

Keywords

Search

Navigation