Why the study?
Previous evidence suggested individual associations between myocardial bridging, atherosclerosis, and epicardial vasospasm, but the complex interplay between these three entities has not been well studied in the North American population.
Does the presence of myocardial bridging and moderate atherosclerosis increase the risk of epicardial vasospasm in patients with angina and nonobstructive coronary arteries?
Does the presence of myocardial bridging and moderate atherosclerosis increase the risk of epicardial vasospasm in patients with angina and nonobstructive coronary arteries?
In patients with angina and nonobstructive coronary arteries, the coexistence of myocardial bridging and moderate atherosclerosis synergistically increases the risk of epicardial vasospasm.
May identify higher-risk ANOCA patients for spasm; hypothesis-generating and should not yet change practice.
Background: Previous evidence suggested individual associations between myocardial bridging (MB), atherosclerosis, and epicardial vasospasm. The complex interplay between these 3 identities has not been well studied in the North American population. Methods: All patients with angina and nonobstructive coronary arteries referred for coronary angiogram who underwent invasive coronary function testing (adenosine and acetylcholine provocation testing) at 2 North American centers between March 2016 and January 2021 were included. The prevalence of epicardial spasm (new >90% stenosis after acetylcholine injection) was assessed according to the presence of MB and moderate atherosclerosis (>50% stenosis or previously stented with negative fractional flow reserve). Conclusions: Epicardial vasospasm occurs most frequently in patients with both MB and moderate atherosclerosis.
No takes yet. Share an insight, caveat, or question.
Bastiany et al. (2025) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: