{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:21:08Z","timestamp":1790734868606,"version":"4.1.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2013,8,22]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The aim of this study was to elucidate the correlation between angiographic coronary vasomotor responses to intracoronary acetylcholine (\n              <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>\n              h) injection, clinical features, and long\u2010term prognosis in patients with vasospastic angina (\n              <jats:styled-content style=\"fixed-case\">VSA<\/jats:styled-content>\n              ).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This is a retrospective, observational, single\u2010center study of 1877 consecutive patients who underwent\n              <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>\n              h\u2010provocation test between January 1991 and December 2010.\n              <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>\n              h\u2010provoked coronary spasm was observed in 873 of 1637 patients included in the present analysis.\n              <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>\n              h\u2010positive patients were more likely to be older male smokers with dyslipidemia, to have a family history of ischemic heart disease, and to have a comorbidity of coronary epicardial stenosis than were\n              <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>\n              h\u2010negative patients.\n              <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>\n              h\u2010positive patients were divided into 2 groups: those with focal (total or subtotal obstruction, n=511) and those with diffuse (severe diffuse vasoconstriction, n=362) spasm patterns. Multivariable logistic regression analysis identified female sex and low comorbidity of coronary epicardial stenosis to correlate with the\n              <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>\n              h\u2010provoked diffuse spasm pattern in patients with\n              <jats:styled-content style=\"fixed-case\">VSA<\/jats:styled-content>\n              .\n              <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>\n              aplan\u2013\n              <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>\n              eier survival curve indicated better 5\u2010year survival rates free from major adverse cardiovascular events in patients with diffuse spasm pattern compared with those with focal spasm pattern (\n              <jats:italic>P<\/jats:italic>\n              =0.019). Multivariable Cox hazard regression analysis identified diffuse spasm pattern as a negative predictor of major adverse cardiovascular events in patients with\n              <jats:styled-content style=\"fixed-case\">VSA<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>\n              h\u2010induced diffuse coronary spasm was frequently observed in female\n              <jats:styled-content style=\"fixed-case\">VSA<\/jats:styled-content>\n              patients free of severe coronary epicardial stenosis and was associated with better prognosis than focal spasm. These results suggest the need to identify the\n              <jats:styled-content style=\"fixed-case\">AC<\/jats:styled-content>\n              h\u2010provoked coronary spasm subtypes in patients with\n              <jats:styled-content style=\"fixed-case\">VSA<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.113.000227","type":"journal-article","created":{"date-parts":[[2013,7,16]],"date-time":"2013-07-16T00:17:21Z","timestamp":1373933841000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":139,"title":["Coronary Vasomotor Response to Intracoronary Acetylcholine Injection, Clinical Features, and Long\u2010term Prognosis in 873 Consecutive Patients With Coronary Spasm: Analysis of a Single\u2010Center Study Over 20\u00a0Years"],"prefix":"10.1161","volume":"2","author":[{"given":"Koji","family":"Sato","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Kaikita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiji","family":"Horio","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takamichi","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Ohba","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Tsujita","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunao","family":"Kojima","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Tayama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Hokimoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiko","family":"Matsui","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Yamaguchi University Hospital, Ube, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seigo","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshige","family":"Yamabe","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisao","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"I147","article-title":"Coronary arterial spasm in ischemic heart disease and its pathogenesis. 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