In patients with ANOCA, coronary vasospasm was associated with a higher lipid index and a greater prevalence of vulnerable plaques (66% vs 38%, p=0.04) compared to those without vasospasm.
Observational (n=75)
Is coronary vasospasm associated with increased lipid burden and plaque vulnerability in patients with ANOCA?
In patients with ANOCA, the presence of coronary vasospasm is associated with a higher lipid burden and increased plaque vulnerability as assessed by OCT.
Absolute Event Rate: 66% vs 38%
p-value: p=0.04
BACKGROUND: An association between atherosclerosis and coronary vasospasm has previously been suggested. However, to date, no conclusive data on the whole spectrum of these disorders have been published. AIMS: This study aimed to define specific morphological features of atherosclerosis in patients with angina and no obstructive coronary artery disease (ANOCA) due to coronary vasospasm. METHODS: From February 2019 to January 2020, we enrolled 75 patients referred to our laboratory for a coronary function test (CFT) due to ANOCA and suspected coronary vasomotor dysfunction. The CFT consisted of an acetylcholine test and a physiology assessment with hyperaemic indexes using adenosine. Patients were divided into two groups according to the presence or absence of coronary vasospasm triggered by acetylcholine (ACH+ and ACH-, respectively). In addition, optical coherence tomography (OCT) was performed to assess the lipid index (LI), a surrogate for lipid area, and the prevalence of markers of plaque vulnerability. RESULTS: ACH+ patients had a higher LI than ACH- patients (LI: 819.85 460.95-2489.03 vs 269.95 243.50-878.05, respectively, p=0.03), and a higher prevalence of vulnerable plaques (66% vs 38%, p=0.04). Moreover, ACH+ patients showed a higher prevalence of neovascularisation compared to ACH- subjects (37% vs 6%, p=0.02) and a trend towards a higher prevalence of all individual markers, in particular thin-cap fibroatheroma (20% vs 0%, p=0.06). No differences were detected between patterns of coronary vasospasm. CONCLUSIONS: The presence of coronary vasospasm, regardless of its phenotype, is associated with higher lipid burden, plaque vulnerability and neovascularisation.
Pellegrini et al. (Mon,) conducted a observational in Angina and no obstructive coronary artery disease (ANOCA) (n=75). Coronary vasospasm triggered by acetylcholine vs. Absence of coronary vasospasm was evaluated on Prevalence of vulnerable plaques (p=0.04). In patients with ANOCA, coronary vasospasm was associated with a higher lipid index and a greater prevalence of vulnerable plaques (66% vs 38%, p=0.04) compared to those without vasospasm.