Angiographic Characteristics of Catheter-Induced Spasm of the Left Main Coronary Artery
Spasm of the left main coronary artery (LM) is considered to be rare. We investigated the angiographic characteristics of the LM in patients with combined LM and disease involving additional vessels, who underwent coronary artery bypass grafting (CABG) and underwent repeat coronary angiography withi...
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| Veröffentlicht in: | The American journal of cardiology 2016-02, Vol.117 (4), p.571-573 |
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| creator | Ilia, Reuben, MD Shimony, Avi, MD Cafri, Carlos, MD Weinstein, Jean Marc, MB, BS |
| description | Spasm of the left main coronary artery (LM) is considered to be rare. We investigated the angiographic characteristics of the LM in patients with combined LM and disease involving additional vessels, who underwent coronary artery bypass grafting (CABG) and underwent repeat coronary angiography within 5 years of the CABG, to examine the apparent frequency of spasm of the LM on initial angiography and its possible predictors. A retrospective analysis was performed of patients who underwent coronary angiography in our institute, who were found to have significant LM stenosis and disease involving additional vessels, underwent CABG and repeat coronary angiography within 5 years of the CABG. Data on angiographic characteristics of the LM on the initial angiogram were investigated. Of 84 patients, 17 (20%) were found to have a normal LM on repeat angiography (group A), and 67 (80%) demonstrated significant stenosis (group B). The degree of LM stenosis was milder in the initial angiogram in group A than in group B (64 ± 15% vs 72 ± 14%, p = 0.047). Most patients in group A demonstrated tubular LM stenosis at initial catheterization in comparison to group B (71% vs 18%). Using multivariate analysis, the only predictor for a normal LM at repeat catheterization was found to be tubular stenosis at initial catheterization (odds ratio 123, 95% confidence interval 4.0 to 3696). In conclusion, LM coronary spasm is a common finding, particularly in those with the appearance of tubular stenosis, and it should be excluded even in patients with additional coronary disease in certain instances to prevent unnecessary CABG. |
| doi_str_mv | 10.1016/j.amjcard.2015.11.039 |
| format | Article |
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We investigated the angiographic characteristics of the LM in patients with combined LM and disease involving additional vessels, who underwent coronary artery bypass grafting (CABG) and underwent repeat coronary angiography within 5 years of the CABG, to examine the apparent frequency of spasm of the LM on initial angiography and its possible predictors. A retrospective analysis was performed of patients who underwent coronary angiography in our institute, who were found to have significant LM stenosis and disease involving additional vessels, underwent CABG and repeat coronary angiography within 5 years of the CABG. Data on angiographic characteristics of the LM on the initial angiogram were investigated. Of 84 patients, 17 (20%) were found to have a normal LM on repeat angiography (group A), and 67 (80%) demonstrated significant stenosis (group B). The degree of LM stenosis was milder in the initial angiogram in group A than in group B (64 ± 15% vs 72 ± 14%, p = 0.047). Most patients in group A demonstrated tubular LM stenosis at initial catheterization in comparison to group B (71% vs 18%). Using multivariate analysis, the only predictor for a normal LM at repeat catheterization was found to be tubular stenosis at initial catheterization (odds ratio 123, 95% confidence interval 4.0 to 3696). In conclusion, LM coronary spasm is a common finding, particularly in those with the appearance of tubular stenosis, and it should be excluded even in patients with additional coronary disease in certain instances to prevent unnecessary CABG.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2015.11.039</identifier><identifier>PMID: 26721654</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Angina pectoris ; Calcification ; Cardiac Catheters - adverse effects ; Cardiology ; Cardiovascular ; Confidence intervals ; Coronary Angiography - methods ; Coronary Artery Bypass - methods ; Coronary Stenosis - diagnostic imaging ; Coronary Stenosis - surgery ; Coronary Vasospasm - diagnostic imaging ; Coronary Vasospasm - etiology ; Coronary vessels ; Coronary Vessels - diagnostic imaging ; Coronary Vessels - physiopathology ; Diabetes ; Female ; Follow-Up Studies ; Humans ; Intubation ; Laboratories ; Male ; Medical imaging ; Middle Aged ; Multivariate analysis ; Retrospective Studies ; Studies ; Time Factors ; Variables ; Veins & arteries</subject><ispartof>The American journal of cardiology, 2016-02, Vol.117 (4), p.571-573</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Feb 15, 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c518t-e893bd35ff41d1edc6c20f4ef308898ed2f947f692cf0f57aa89714484786d283</citedby><cites>FETCH-LOGICAL-c518t-e893bd35ff41d1edc6c20f4ef308898ed2f947f692cf0f57aa89714484786d283</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1763003384?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,782,786,3552,27931,27932,46002,64392,64394,64396,72476</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26721654$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ilia, Reuben, MD</creatorcontrib><creatorcontrib>Shimony, Avi, MD</creatorcontrib><creatorcontrib>Cafri, Carlos, MD</creatorcontrib><creatorcontrib>Weinstein, Jean Marc, MB, BS</creatorcontrib><title>Angiographic Characteristics of Catheter-Induced Spasm of the Left Main Coronary Artery</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Spasm of the left main coronary artery (LM) is considered to be rare. We investigated the angiographic characteristics of the LM in patients with combined LM and disease involving additional vessels, who underwent coronary artery bypass grafting (CABG) and underwent repeat coronary angiography within 5 years of the CABG, to examine the apparent frequency of spasm of the LM on initial angiography and its possible predictors. A retrospective analysis was performed of patients who underwent coronary angiography in our institute, who were found to have significant LM stenosis and disease involving additional vessels, underwent CABG and repeat coronary angiography within 5 years of the CABG. Data on angiographic characteristics of the LM on the initial angiogram were investigated. Of 84 patients, 17 (20%) were found to have a normal LM on repeat angiography (group A), and 67 (80%) demonstrated significant stenosis (group B). The degree of LM stenosis was milder in the initial angiogram in group A than in group B (64 ± 15% vs 72 ± 14%, p = 0.047). Most patients in group A demonstrated tubular LM stenosis at initial catheterization in comparison to group B (71% vs 18%). Using multivariate analysis, the only predictor for a normal LM at repeat catheterization was found to be tubular stenosis at initial catheterization (odds ratio 123, 95% confidence interval 4.0 to 3696). In conclusion, LM coronary spasm is a common finding, particularly in those with the appearance of tubular stenosis, and it should be excluded even in patients with additional coronary disease in certain instances to prevent unnecessary CABG.</description><subject>Angina pectoris</subject><subject>Calcification</subject><subject>Cardiac Catheters - adverse effects</subject><subject>Cardiology</subject><subject>Cardiovascular</subject><subject>Confidence intervals</subject><subject>Coronary Angiography - methods</subject><subject>Coronary Artery Bypass - methods</subject><subject>Coronary Stenosis - diagnostic imaging</subject><subject>Coronary Stenosis - surgery</subject><subject>Coronary Vasospasm - diagnostic imaging</subject><subject>Coronary Vasospasm - etiology</subject><subject>Coronary vessels</subject><subject>Coronary Vessels - diagnostic imaging</subject><subject>Coronary Vessels - physiopathology</subject><subject>Diabetes</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Intubation</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Retrospective Studies</subject><subject>Studies</subject><subject>Time Factors</subject><subject>Variables</subject><subject>Veins & arteries</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkUtv1DAQgC0EokvhJ4AiceklwWPnYV9AqwhopUUcCuJoufa465DHYieV9t_jaBeQeuFkefzNjOcbQl4DLYBC_a4r9NAZHWzBKFQFQEG5fEI2IBqZgwT-lGwopSyXUMoL8iLGLl0Bqvo5uWB1w6Cuyg35sR3v_XQf9GHvTdbuddBmxuDj7E3MJpe1et5jiuQ3o10M2uz2oOOwvqR4tkM3Z1-0H7N2CtOowzHbhkQfX5JnTvcRX53PS_L908dv7XW--_r5pt3uclOBmHMUkt9ZXjlXggW0pjaMuhIdp0JIgZY5WTaulsw46qpGayEbKEtRNqK2TPBLcnWqewjTrwXjrAYfDfa9HnFaooKmZrxkUtQJffsI7aYljOl3K8Up5VyUiapOlAlTjAGdOgQ_pMEUULWaV506m1ereQWgkvmU9-Zcfbkb0P7N-qM6AR9OACYdDx6DisbjmJT6gGZWdvL_bfH-UQXT-9Eb3f_EI8Z_06jIFFW36_rX7UNFGWcc-G_Vd6qR</recordid><startdate>20160215</startdate><enddate>20160215</enddate><creator>Ilia, Reuben, MD</creator><creator>Shimony, Avi, MD</creator><creator>Cafri, Carlos, MD</creator><creator>Weinstein, Jean Marc, MB, BS</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7Z</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160215</creationdate><title>Angiographic Characteristics of Catheter-Induced Spasm of the Left Main Coronary Artery</title><author>Ilia, Reuben, MD ; 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We investigated the angiographic characteristics of the LM in patients with combined LM and disease involving additional vessels, who underwent coronary artery bypass grafting (CABG) and underwent repeat coronary angiography within 5 years of the CABG, to examine the apparent frequency of spasm of the LM on initial angiography and its possible predictors. A retrospective analysis was performed of patients who underwent coronary angiography in our institute, who were found to have significant LM stenosis and disease involving additional vessels, underwent CABG and repeat coronary angiography within 5 years of the CABG. Data on angiographic characteristics of the LM on the initial angiogram were investigated. Of 84 patients, 17 (20%) were found to have a normal LM on repeat angiography (group A), and 67 (80%) demonstrated significant stenosis (group B). The degree of LM stenosis was milder in the initial angiogram in group A than in group B (64 ± 15% vs 72 ± 14%, p = 0.047). Most patients in group A demonstrated tubular LM stenosis at initial catheterization in comparison to group B (71% vs 18%). Using multivariate analysis, the only predictor for a normal LM at repeat catheterization was found to be tubular stenosis at initial catheterization (odds ratio 123, 95% confidence interval 4.0 to 3696). In conclusion, LM coronary spasm is a common finding, particularly in those with the appearance of tubular stenosis, and it should be excluded even in patients with additional coronary disease in certain instances to prevent unnecessary CABG.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26721654</pmid><doi>10.1016/j.amjcard.2015.11.039</doi><tpages>3</tpages></addata></record> |
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| subjects | Angina pectoris Calcification Cardiac Catheters - adverse effects Cardiology Cardiovascular Confidence intervals Coronary Angiography - methods Coronary Artery Bypass - methods Coronary Stenosis - diagnostic imaging Coronary Stenosis - surgery Coronary Vasospasm - diagnostic imaging Coronary Vasospasm - etiology Coronary vessels Coronary Vessels - diagnostic imaging Coronary Vessels - physiopathology Diabetes Female Follow-Up Studies Humans Intubation Laboratories Male Medical imaging Middle Aged Multivariate analysis Retrospective Studies Studies Time Factors Variables Veins & arteries |
| title | Angiographic Characteristics of Catheter-Induced Spasm of the Left Main Coronary Artery |
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