Vasospastic Angina is Still Prevalent in a Local Ehime Prefecture in Japan

Background: We analyzed the incidence of angiographically confirmed vasospastic angina (VSA) patients and these coronary risk factors from 1991 and 2009 in a local Ehime prefecture in Japan, retrospectively. Methods and Results: We performed total diagnostic 4435 coronary angiography (CAG), 1307 percutaneous coronary intervention (PCI) and 2244 spasm provocation tests from 1991 and 2009. Angiographically confirmed 624 VSA patients were diagnosed by the definition of transient luminal narrowing >90% and usual chest pain or ischemic ECG changes. We compared the annual incidence of VSA and coronary risk factors from 1991–2000 and 2001–2009. Whereas the number of PCI increased twice and the number of spasm provocation tests decreased in 2001–2009, the total number of VSA diagnosed by angiography increased in 2001–2009 compared with that in 1991–2000 (339 pts vs 285 pts). The value of VSA pts/year significantly increased in 2001–2009 (37.7±11.4 vs 28.5±11.8 pts/year, p<0.01). Variant angina decreased and post PCI patients increased in 2001–2009. The incidence of dyslipidemia was significantly increased in 2001–2009. The values of total cholesterol, triglycerides, low-density-lipoprotein (LDL) cholesterol, fasting blood sugar were also significantly increased in 2001–2009. Conclusions: The frequency of VSA in Ehime has increased. We should pay more attention to coronary artery spasm in the cardiac catheterization laboratory.