ArticleJournal of the American Heart Association2016
Impact of Renin-Angiotensin System Inhibitors on Long-Term Clinical Outcomes of Patients With Coronary Artery Spasm.
Article in Journal of the American Heart Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
17 citing papers in PubMed, 28 citations in OpenAlex.
- Unveiling the invisible culprit: a multimodality approach for myocardial infarction with non-obstructive coronary arteries diagnosis-a case report.European heart journal. Case reports · 2025Article
- ANOCA, INOCA, MINOCA: The New Frontier of Coronary Syndromes.Journal of cardiovascular development and disease · 2025Review
- Coronary Microvascular Dysfunction and Vasospastic Angina-Pathophysiology, Diagnosis and Management Strategies.Journal of clinical medicine · 2025Review
- A Case of Refractory Variant Angina.Cureus · 2024Article
- Pharmacotherapy in patients with vasomotor disorders.International journal of cardiology. Heart & vasculature · 2023Review
- Efficacy and safety of the endothelin-1 receptor antagonist macitentan in epicardial and microvascular vasospasm; a proof-of-concept study.International journal of cardiology. Heart & vasculature · 2023Article
- Contemporary and future invasive coronary vasomotor function testing and treatment in patients with ischaemia with no obstructive coronary arteries.European heart journal supplements : journal of the European Society of Cardiology · 2022Article
- Sex Difference in Coronary Artery Spasm Tested by Intracoronary Acetylcholine Provocation Test in Patients with Nonobstructive Coronary Artery Disease.Journal of interventional cardiology · 2022Article
- Vasospastic Angina: A Contemporary Review of its Pathophysiology, Diagnosis and Management.Heart international · 2022Review
- Pathobiology and evolving therapies of coronary artery vasospasm.Proceedings (Baylor University. Medical Center) · 2021Review
- Outpatient Management of Patients With Angina With No Obstructive Coronary Arteries: How to Come to a Proper Diagnosis and Therapy.Frontiers in cardiovascular medicine · 2021Review
- Association of Major Adverse Cardiac Events up to 5 Years in Patients With Chest Pain Without Significant Coronary Artery Disease in the Korean Population.Journal of the American Heart Association · 2019Article
- Coronary artery spasm - Clinical features, pathogenesis and treatment.Proceedings of the Japan Academy. Series B, Physical and biological sciences · 2019Review
- Impact of Insulin Resistance on Acetylcholine-Induced Coronary Artery Spasm in Non-Diabetic Patients.Yonsei medical journal · 2018Article
- The multi-vessel and diffuse coronary spasm is a risk factor for persistent angina in patients received anti-angina medication.Medicine · 2018Observational
- Vasospastic angina: a review on diagnostic approach and management.Therapeutic advances in cardiovascular diseaseReview
- Diagnosis and treatment of patients with ANOCA. Consensus document of the SEC-Clinical Cardiology Association/SEC-Interventional Cardiology Association/SEC-Ischemic Heart Disease and Acute Cardiac Care Association/ SEC-Cardiovascular Imaging Association.REC, interventional cardiologyArticle
Corrections and comments
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Authors and funding
21 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCoronary artery spasm (CAS) is a well-known endothelial dysfunction, and a major cause of vasospastic angina (VSA). The renin-angiotensin system (RAS) is known to be closely associated with endothelial function. However, there are only a few studies that investigated the impact of RAS inhibitor on long-term clinical outcomes in VSA patients. METHODS AND
resultsA total of 3349 patients with no significant coronary artery disease, diagnosed with CAS by acetylcholine provocation test were enrolled for this study. Significant CAS was defined as having ≥70% narrowing of the artery after incremental injections of 20, 50, and 100 μg of acetylcholine into the left coronary artery. Patients were divided into 2 groups according to whether the prescription included RAS inhibitor or not (RAS inhibitor group: n=666, non-RAS inhibitor group; n=2683). To adjust for any potential confounders that could cause bias, propensity score matching (PSM) analysis was performed using a logistic regression model. After PSM analysis, 2 matched groups (524 pairs, n=1048 patients, C-statistic=0.845) were generated and their baseline characteristics were balanced. During the 5-year clinical follow-up, the RAS inhibitor group showed a lower incidence of recurrent angina (8.7% versus 14.1%, P=0.027), total death (0.0% versus 1.3%, P=0.045), and total major adverse cardiovascular events (1.0% versus 4.1%, P=0.026) than the non-RAS inhibitor group.
conclusionsChronic RAS inhibitor therapy was associated with lower incidence of cardiovascular events in VSA patients in the 5-year clinical follow-up.
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