{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T09:45:32Z","timestamp":1785577532921,"version":"3.56.0"},"reference-count":19,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T00:00:00Z","timestamp":1673481600000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2022,12,21]]},"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Coronary artery vasospasm is an abnormal spasm of coronary arteries that cause transient or complete occlusion without exertion. It causes stable angina to ACS. However, this can be prevented by calcium channel blockers (CCBs) which suppress Ca<jats:sup>2+<\/jats:sup> influx into the vascular muscle cells. Nevertheless, several CCBs adverse effects are harmful for these patients. Selecting the right CCBs would give the best clinical practice.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Method<\/jats:title>\n                  <jats:p>The studies were obtained from four major medical databases by various keywords. Inclusion and exclusion criteria were implemented as adult &gt;18 years, observational study, English language and drug of interest. Duplicates were eliminated, and the remaining studies were reviewed. Final full-texts assessment was conducted independently by Newcastle-Ottawa Scale and Revised Cochrane.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The search found 1378 articles. However, six studies were selected after implementing the study criteria. Diltiazem was found to decrease angina and increase quality of life until 12th week of treatment; however, some adverse effects include atrioventricular block and recurrent angina up till 4th week were found. Meanwhile, nifedipine was found to decrease vasospastic angina (VSA) by the fourth and eighth weeks of treatment. Nevertheless, it caused excessive drop in BP and increase heart rate by eighth week. In addition, slow-release preparation of both CCBs were found to increase efficacy and compliance. Lastly amlodipine was also found to decrease VSA by 17%\u00b1140%\u2009and 33% after 6 weeks, but further studies needed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Diltiazem, nifedipine and amlodipine are potent in decreasing VSA, however, tailoring specific CCBs adverse reactions to patient condition and the drug preparation would be substantially beneficial for the outcome.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2022-002179","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T09:49:15Z","timestamp":1673516955000},"page":"e002179","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Comparison of various calcium antagonist on vasospastic angina: a systematic review"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4968-8817","authenticated-orcid":false,"given":"Jaspal","family":"Singh","sequence":"first","affiliation":[{"name":"Emergency Department, Rumah Sakit Umum Daerah Dr Pirngadi Kota Medan, Medan, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Elton","sequence":"additional","affiliation":[{"name":"Mitra Keluarga Hospital Group, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melvin","family":"Kwa","sequence":"additional","affiliation":[{"name":"University of Indonesia Hospital, Depok, Jawa Barat, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,1,12]]},"reference":[{"key":"2025081710330362000_10.1.e002179.1","unstructured":"Swarup S , Patibandla S , Grossman SA . Coronary Artery Vasospasm. In: StatPearls. Treasure Island: StatPearls Publishing, 2021."},{"key":"2025081710330362000_10.1.e002179.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2010.07.010"},{"key":"2025081710330362000_10.1.e002179.3","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-66-0098"},{"key":"2025081710330362000_10.1.e002179.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.09.017"},{"key":"2025081710330362000_10.1.e002179.5","doi-asserted-by":"publisher","DOI":"10.1177\/1074248416640161"},{"key":"2025081710330362000_10.1.e002179.6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239039"},{"key":"2025081710330362000_10.1.e002179.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2009.11.005"},{"key":"2025081710330362000_10.1.e002179.8","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-305986"},{"key":"2025081710330362000_10.1.e002179.9","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1007\/s12013-014-0498-z","article-title":"The use of calcium channel blockers in the treatment of coronary spasm and atrioventricular block","volume":"72","author":"Gao","year":"2015","journal-title":"Cell Biochem Biophys"},{"key":"2025081710330362000_10.1.e002179.10","doi-asserted-by":"crossref","first-page":"90","DOI":"10.3349\/ymj.2017.58.1.90","article-title":"Impact of diltiazem alone versus diltiazem with nitrate on five-year clinical outcomes in patients with significant coronary artery spasm","volume":"58","author":"Park","year":"2017","journal-title":"Yonsei Med J"},{"key":"2025081710330362000_10.1.e002179.11","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.acvd.2018.08.002","article-title":"Vasospastic angina: a literature review of current evidence","volume":"112","author":"Picard","year":"2019","journal-title":"Arch Cardiovasc Dis"},{"key":"2025081710330362000_10.1.e002179.12","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/S0002-9149(97)00389-5","article-title":"Effect of morning versus evening dosing of diltiazem on myocardial ischemia detected by ambulatory electrocardiographic monitoring in chronic stable angina pectoris. Dilacor XR ambulatory ischemia Study Group","volume":"80","author":"Deedwania","year":"1997","journal-title":"Am J Cardiol"},{"key":"2025081710330362000_10.1.e002179.13","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.ahj.2004.08.002","article-title":"Efficacy and safety of a once-daily graded-release diltiazem formulation dosed at bedtime compared to placebo and to morning dosing in chronic stable angina pectoris","volume":"149","author":"Glasser","year":"2005","journal-title":"Am Heart J"},{"key":"2025081710330362000_10.1.e002179.14","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1111\/j.1600-0773.1985.tb03575.x","article-title":"Diltiazem and propranolol, alone and in combination, on exercise performance and left ventricular function in patients with stable effort angina: a double-blind, randomized, and placebo-controlled study","volume":"57 Suppl 2","author":"Schroeder","year":"1985","journal-title":"Acta Pharmacol Toxicol"},{"key":"2025081710330362000_10.1.e002179.15","unstructured":"Nifedipine therapy for Prinzmetal\u2019s angina - PubMed [Internet]. Available: https:\/\/pubmed.ncbi.nlm.nih.gov\/411609\/ [Accessed 21 Jun 2021]."},{"key":"2025081710330362000_10.1.e002179.16","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3904\/kjim.2020.628","article-title":"A new perspective on calcium channel blockers in vasospastic angina","volume":"36","author":"Kim","year":"2021","journal-title":"Korean J Intern Med"},{"key":"2025081710330362000_10.1.e002179.17","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90310-W"},{"key":"2025081710330362000_10.1.e002179.18","doi-asserted-by":"publisher","DOI":"10.1002\/bdd.2510120508"},{"key":"2025081710330362000_10.1.e002179.19","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(91)90347-N"}],"container-title":["Open Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/openhrt-2022-002179","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,17]],"date-time":"2025-08-17T17:33:16Z","timestamp":1755451996000},"score":1,"resource":{"primary":{"URL":"https:\/\/openheart.bmj.com\/lookup\/doi\/10.1136\/openhrt-2022-002179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1,12]]},"published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1136\/openhrt-2022-002179"],"URL":"https:\/\/doi.org\/10.1136\/openhrt-2022-002179","relation":{},"ISSN":["2053-3624"],"issn-type":[{"value":"2053-3624","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]}}}