Key result
Endothelial dysfunction and smooth muscle hyperreactivity drive coronary artery spasm, with smoking the primary modifiable risk.
Why the study?
Coronary artery spasm is underrecognized due to limited access to pharmacological provocation testing, and its distinct risk profile and mechanisms require synthesis to improve phenotype-informed risk stratification and precision management.
This review provides an integrated framework of the mechanisms and risk factors for coronary artery spasm, emphasizing the need for phenotype-informed precision management in patients with INOCA and MINOCA.
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Supports provocation testing for CAS in INOCA/MINOCA; extends mechanistic models but leaves open phenotype-specific trials.
Kuang et al. (2026) conducted a review in Coronary artery spasm (CAS). Coronary artery spasm is a multifactorial vasomotor disorder driven by endothelial dysfunction and vascular smooth muscle hyperreactivity, with smoking as the most established modifiable risk factor.
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