{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T06:10:15Z","timestamp":1776319815793,"version":"3.50.1"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,10,26]]},"abstract":"\n Background<\/jats:title>\n \n Coronary vasospasm is an important pathogenesis of acute coronary syndrome (\n ACS<\/jats:styled-content>\n ). However, the clinical features and prognosis of vasospastic angina (\n VA<\/jats:styled-content>\n ) patients presenting with\n ACS<\/jats:styled-content>\n (\n VAACS<\/jats:styled-content>\n ) are still unclear. We aimed to evaluate the clinical characteristics and long\u2010term outcomes of\n VAACS<\/jats:styled-content>\n patients without significant coronary artery stenosis.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n A total of 986\n VA<\/jats:styled-content>\n patients confirmed by ergonovine provocation test were analyzed.\n VAACS<\/jats:styled-content>\n was defined as\n VA<\/jats:styled-content>\n patients visiting the emergency room with documented electrocardiographic changes, significant arrhythmias, or elevated cardiac biomarkers.\n VA<\/jats:styled-content>\n patients with elevated cardiac biomarkers were further considered to have myocardial infarction (\n MI<\/jats:styled-content>\n ;\n VAMI<\/jats:styled-content>\n ). During 4.4\u00a0years of median follow\u2010up, we investigated major adverse cardiac events including cardiac death,\n MI<\/jats:styled-content>\n , revascularization, and rehospitalization because of recurrent angina. The\n VAACS<\/jats:styled-content>\n group consisted of 149 patients (15.1%), and\n VAMI<\/jats:styled-content>\n occurred in 81 patients (8.2%).\n VAACS<\/jats:styled-content>\n patients were younger and had a higher prevalence of diabetes mellitus,\n MI<\/jats:styled-content>\n history, and higher levels of inflammatory markers compared with non\u2010\n VAACS<\/jats:styled-content>\n patients. In multivariable Cox regression analyses,\n VAACS<\/jats:styled-content>\n patients were associated with an increased risk of major adverse cardiac events (hazard ratio, 1.65; 95%\n CI<\/jats:styled-content>\n 1.14\u20132.37;\n P<\/jats:italic>\n =0.007) and recurrent\n MI<\/jats:styled-content>\n hazard ratio, 2.57; 95%\n CI<\/jats:styled-content>\n , 1.35\u20134.87;\n P<\/jats:italic>\n =0.004). In addition,\n VAMI<\/jats:styled-content>\n patients had an increased risk of major adverse cardiac events (hazard ratio, 1.75; 95%\n CI<\/jats:styled-content>\n , 1.11\u20132.76;\n P<\/jats:italic>\n =0.016) and recurrent\n MI<\/jats:styled-content>\n (hazard ratio, 2.43; 95%\n CI<\/jats:styled-content>\n , 1.09\u20135.40;\n P<\/jats:italic>\n =0.03).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n VAACS<\/jats:styled-content>\n patients showed worse clinical outcomes, driven mainly by recurrent\n MI<\/jats:styled-content>\n . Therefore, intensive medical treatment might be required in\n VAACS<\/jats:styled-content>\n patients.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.004336","type":"journal-article","created":{"date-parts":[[2016,11,17]],"date-time":"2016-11-17T03:55:23Z","timestamp":1479354923000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Clinical Outcomes of Vasospastic Angina Patients Presenting With Acute Coronary Syndrome"],"prefix":"10.1161","volume":"5","author":[{"given":"Sung Woo","family":"Cho","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taek Kyu","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hye Bin","family":"Gwag","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. Young","family":"Lim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min Seok","family":"Oh","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Da Hyon","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Choong Sil","family":"Seong","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeong Hoon","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young Bin","family":"Song","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joo\u2010Yong","family":"Hahn","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin\u2010Ho","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyeon\u2010Cheol","family":"Gwon","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung\u2010Hyuk","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00073-X"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.037283"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2008.01.001"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.07.018"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-66-0098"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2011.12.106"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs199"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.12.249"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.08.001"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.04.050"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.08.626"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.114.000795"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2010.07.008"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2015.09.013"},{"key":"e_1_3_2_16_2","first-page":"1169","article-title":"Rebound of vasospastic angina after cessation of long\u2010term treatment with nifedipine","volume":"130","author":"Lette J","year":"1984","unstructured":"Lette J, Gagnon RM, Lemire JG, Morissette M. Rebound of vasospastic angina after cessation of long\u2010term treatment with nifedipine. Can Med Assoc J. 1984;130:1169\u20131171, 1174.","journal-title":"Can Med Assoc J"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.110.959809"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.71.1383"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.116.004336","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:22:04Z","timestamp":1715595724000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.116.004336"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,26]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2016,10,26]]}},"alternative-id":["10.1161\/JAHA.116.004336"],"URL":"https:\/\/doi.org\/10.1161\/jaha.116.004336","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,10,26]]},"assertion":[{"value":"2016-07-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-11-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e004336"}}