Key result
Stent implantation in patients with variant angina and severe organic stenosis resulted in a similar incidence of major adverse cardiovascular events compared to medical therapy alone (9% vs 11%, p=0.781).
Why the study?
Most patients with variant angina respond well to CCB or nitrates, but organic stenosis is a risk factor, prompting investigation into the prognosis of stent implantation in these patients.
Does stent implantation reduce MACE in variant angina patients with severe organic stenosis compared to medical therapy alone?
Observational (n=69)
No
Does stent implantation reduce MACE in variant angina patients with severe organic stenosis compared to medical therapy alone?
Absolute Event Rate: 9% vs 11%
p-value: p=0.781
In patients with variant angina and severe organic stenosis, stent implantation combined with medical therapy resulted in similar rates of MACE compared to medical therapy alone over a 24-month follow-up.
Should not yet change practice in variant angina with stenosis; leaves open whether PCI reduces MACE in randomized trials.
Objective: To explore the prognosis of stent implantation on variant angina (VA) with severe organic stenosis. Background: Vasospasm is the pathogenesis of VA. Most VA patients are effective on calcium channel blockers (CCB) or nitrates, and the prognosis is generally good, but organic stenosis is a risk factor for VA. Method: We collected 141 VA patients treated with CCB and (or) nitrates in the First Affiliated Hospital of Zhengzhou University from December 2010 to June 2019. VA patients with diameter stenosis ≥50% were enrolled .They were divided into two groups according to the presence of stent implantation. The main adverse cardiovascular events (MACE) were observed including cardiogenic death, non-fatal myocardial infarction, readmission due to angina attack, coronary revascularization and heart failure. Results: 69 cases were included: 33 cases received stent implantation and 36 cases received medical treatment. The proportion of left anterior descending (LAD)(48% vs 44%,p=0.737 )which was the culprit coronary artery was very high. Diameter stenosis (84.3%±6.5 %VS 59.9%±010.1%，P<0.001)in stenting group was higher than that in stent-free group. Following up for 24 ± 23 months, there was no significant difference in the incidence of MACE (9% VS 11%) including cardiac death (3% VS 2.8%), coronary revascularization (0% VS 3%) and readmission due to angina (6% VS 5.6%), and effectiveness (88% VS 89%) between the two groups. CONCLUSION: Although the two groups showed similar clinical outcomes, with anti-spastic and antiplatelet medication, stent implantation was of benefit to the prognosis of VA with severe organic stenosis.
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Sang et al. (2019) conducted an observational in Variant angina with severe organic stenosis (n=69). Stent implantation vs. Medical treatment (calcium channel blockers and/or nitrates) was evaluated on Main adverse cardiovascular events (MACE) (p=0.781). Stent implantation in patients with variant angina and severe organic stenosis resulted in a similar incidence of major adverse cardiovascular events compared to medical therapy alone (9% vs 11%, p=0.781).
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