Clinicalanalysis Of Coronary Artery Spasm Syndrome

Objective to investigate the clinical features and prognosis of coronary artery spasm syndrome.Methods Forty-three patients diagnosed as coronary spasm were enrolled continuously from January 2014 to December 2019 in the inpatient department of Cardiology of the first hospital of Chongqing Medical college.Fifty one patients with no significant coronary artery stenosis in the same period were compared.The clinical characteristics were analyzed.all the patients were followed up and clinical outcome was recorded and analyzed.Results Among the 43 patients with coronary spasm,there were 34 males and 9 females,aged 37-85 years,including 18 cases of resting angina pectoris,14 cases of postactive angina pectoris,8 cases of myocardial infarction,3 cases of syncope,24 cases of smoking history,35 cases of transient ST segment elevation and 2 cases of ST segment depression.42cases(97.7%)were followed up.Loss of follow-up in 1 case(2.4%);There were no MACE events in 29 cases and MACE events in 13 cases,including3 cases of death,10 cases of recurrent angina pectoris and 8 cases of PCItreatment.There was no significant difference in age and sex between the case group and the normal group.The proportion of smoking and drinking,TC,LDL-C,Apo-A,FT3 and FT4 in the case group were higher than those in the normal group.The risk factors of smoking,cholesterol,low density lipoprotein cholesterol,lipoprotein A,FT3 and FT47 were further analyzed by stepwise binary Logistic regression analysis.Smoking and low density lipoprotein were independent risk factors for coronary artery spasm.The proportion of smoking,history of drinking,TG and diabetes mellitus in the adverse event group were higher than those in the non-adverse event group,suggesting that smoking and drinking with high blood fat were prone to MACE events.Stepwise binary Logistic regression analysis was conducted to analyze the risk factors of smoking,cholesterol,low density lipoprotein cholesterol,lipoprotein A,FT3 and FT47,among which smoking was an independent risk factor for coronary artery spasm.Conclusion The prevalence rate of coronary spasm in males was significantly higher than that in females.Patients with previous smoking history and hyperlipidemia were more likely to suffer from coronary spasm.Smoking and elevated LDL-C were independent risk factors for coronary spasm.Smoking was an independent risk factor for MACE in patients with coronary spasm,and most of the patients had a good prognosis,but there were still some patients with recurrent symptoms of angina pectoris and anincrease in the incidence of major cardiac events.PCI may be considered in fewer patients.