What question did this study set out to answer?

To determine whether coronary arterial spasm in variant angina results from specific abnormal agonist-receptor interactions or a local nonspecific coronary supersensitivity to diverse stimuli.

December 1, 1986CirculationOpen Access

Local coronary supersensitivity to diverse vasoconstrictive stimuli in patients with variant angina.

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Why the study?

Do diverse vasoconstrictive stimuli induce coronary spasm in patients with variant angina?

Key Points

To determine whether coronary arterial spasm in variant angina results from specific abnormal agonist-receptor interactions or a local nonspecific coronary supersensitivity to diverse stimuli.
Administered a series of provocative vasoconstrictive tests—including ergonovine, hyperventilation, handgrip, cold pressor, exercise, and histamine (last 15 patients)—to 28 patients with vasospastic angina.
Evaluated short-term reproducibility across provocative tests in at least 23 patients and compared responses between patients with normal/nonsignificant versus significant coronary stenoses.
Coronary spasm was provoked by ergonovine in 96% of patients, hyperventilation in 54%, histamine in 47%, exercise in 46%, cold pressor in 11%, and handgrip in 7%.
In the same individual, at least two distinct vasoconstrictive stimuli induced spasm in 82% of patients and three or more stimuli provoked spasm in 39%, with no significant differences observed based on underlying coronary stenosis severity.

Structured PICO

Do diverse vasoconstrictive stimuli induce coronary spasm in patients with variant angina?

Population

28 patients with vasospastic angina (variant angina)

Intervention

Series of diverse vasoconstrictive stimuli (ergonovine, hyperventilation, handgrip, cold pressor, and exercise-tests in all 28 patients; histamine in 15 patients)

Outcome

Provocation of coronary arterial spasmsurrogate

Patients with variant angina exhibit a local nonspecific supersensitivity to diverse vasoconstrictive stimuli, suggesting a generalized hyperreactivity rather than a specific receptor abnormality.

Discussion

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Implication

Suggests nonspecific supersensitivity in variant angina; hypothesis-generating for mechanisms and provocation protocols.

Cite This Study

Kaski et al. (1986) studied this question.

synapsesocial.com/papers/6a71d09f2163a0a01bc5cb8a https://doi.org/10.1161/01.cir.74.6.1255

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Local coronary supersensitivity to diverse vasoconstrictive stimuli in patients with variant angina.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Local coronary supersensitivity to diverse vasoconstrictive stimuli in patients with variant angina.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider