Clinical and laboratory characteristics in patients with acute myocardial infarction due to occlusive vasospasm

Abstract

Background: The purpose of this study was to determine the clinical and laboratory characteristics in patients with acute myocardial infarction (AMI) associated with coronary vasospasm.

Methods and results: Consecutive 231 patients with documented coronary vasospasm by ergonovine provocation test but with a normal-appearing coronary angiogram were divided into two groups, variant angina pectoris (VAP) patients (group I; n=202, 49.5 ± 11.1 years) and AMI patients (group II; n=29, 47.4 ± 11.2 years). Matched control patients were 84 AMI patients with significant stenosis (>50%) (group III; n=84, 61.2 ± 11.8 years). Although, the incidence of hypertension, diabetes mellitus, and smoking were lower in group I than in group III, there was no difference between group II and III (diabetes, 7.9% vs. 13.8% vs. 29.8%; hypertension, 19.8% vs. 24.1% vs. 41.7%; smoking 48% vs. 48.3% vs. 61.9%; respectively, p<0.01). Measured high-sensitivity C-reactive protein (hsCRP) and fibrinogen level were higher (respectively, p<0.001, p<0.001) in groups II and III (group II, 1.88 ± 2.9 mg/dl, 317.5 ± 51.2mg/dl; group III, 2.92 ± 3.9 mg/dl, 326.8 ± 107.7 mg/dl) than those in group I (0.68 ± 1.5mg/dl, 263.2 ± 70.3mg/dl). A correlation was clearly seen between fibrinogen and hsCRP (r=0.472, p<0.001).

Conclusion: The clinical characteristics of patients with AMI associated with spasm were similar to those with VAP, but laboratory findings were similar to those of AMI in patients with significant stenosis.