Cardiovascular Prevention and Pharmacotherapy

Original Articles

Safety and efficacy of low-dose aspirin in patients with coronary artery spasm: long-term clinical follow-up: Byoung Geol Choi, Kyung-Hee Kim, Seung-Woon Rha; Cardiovasc Prev Pharmacother. 2022;4(1):26-33. Published online January 21, 2022; DOI: https://doi.org/10.36011/cpp.2022.4.e6

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Background
Aspirin is known to aggravate coronary artery spasm (CAS) regardless of the dose (100–325 mg/day). However, it is unclear whether low-dose aspirin (LDA; 100 mg) has deleterious impacts on the clinical course of CAS patients in the long-term. Thus, we investigated the impact of LDA on the long-term clinical outcomes of CAS patients.
Methods
A total of 5,697 consecutive patients without significant coronary artery disease who underwent an acetylcholine provocation test from November 2004 to May 2015 were enrolled. Of these patients, 3,072 CAS patients were enrolled in the study and divided into two groups based on whether they took LDA: the LDA group (n=338) and the non-LDA group (n=2,734). All CAS patients were prescribed anti-anginal medication as appropriate. To adjust for any potential confounders that could cause bias, a propensity score matching analysis was performed using a logistic regression model.
Results
After propensity score matching, two propensity-matched groups (524 pairs, 1,048 patients, C-statistic=0.827) were generated, and the baseline characteristics of the two groups were balanced. The two groups were showed no significant differences in any follow-up events, such as major adverse cardiac events and recurrent angina.
Conclusions
The main finding of the present study is that the use of LDA did not affect cardiovascular events up to 5 years in CAS patients. Therefore, the prescription of LDA in these patients should be individualized considering their clinical status.

Citations

Citations to this article as recorded by

Long-term prognostic factors for cardiovascular events in patients with chest pain without diabetes mellitus nor significant coronary stenosis
Seung-Woon Rha, Kyuho Lee, Se Yeon Choi, Jae Kyeong Byun, Jinah Cha, Sujin Hyun, Woo Jin Ahn, Soohyung Park, Dong Oh Kang, Eun Jin Park, Cheol Ung Choi, Byoung Geol Choi
Heart and Vessels.2024; 39(5): 382. CrossRef

Aspirin Has a Neutral Effect in Preventing Future Cardiovascular Events in Vasospastic Angina: Kwan Yong Lee, Dong Il Shin, Sung Ho Her, Seung Hwan Han, Youngkeun Ahn, Dong-Soo Kim, Dong-Ju Choi, Hyuck Moon Kwon, Hyeon-Cheol Gwon, Seung-Woon Rha, Sang-Ho Jo, Sung Cil Lim, Jun-Pyo Myong, Sang Hong Baek; Cardiovasc Prev Pharmacother. 2019;1(1):30-42. Published online July 31, 2019; DOI: https://doi.org/10.36011/cpp.2019.1.e4; Correction in: Cardiovasc Prev Pharmacother 2020;2(1):31

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Background
The aim of this multi-center prospective registry study was to evaluate the clinical efficacy of low-dose aspirin in vasospastic angina (VA) patients for the prevention of future cardiovascular events.
Methods
A total of 1,717 patients with positive and intermediate results of an intracoronary ergonovine provocation test in the VA in Korea registry (n=2,960) were classified into 100 mg/day aspirin intake (aspirin, n=743) and no-aspirin intake (control, n=974) groups. The primary end-point was a composite of major adverse cardiac events (MACEs) including cardiac death, new-onset arrhythmia, and acute coronary syndrome.
Results
The median follow-up duration was 2.0 years (25–75th, interquartile range 0.9–3.0 years). Cumulative composite MACE in the propensity score matched-pair cohort (n=1,028) was 3.6%. There was no significant difference in composite MACE between the aspirin and control groups (3.1% vs. 4.1%; hazard ratio [HR], 1.18; 95% confidence interval [CI], 0.61–2.26; p=0.623). A sensitivity analysis of only the VA-positive population showed these results to be consistent. Even for patients with minimal organic stenosis (n=369), aspirin usage was not related to the incidence of a composite MACE (HR, 1.61; 95% CI, 0.55–4.72; p=0.380).
Conclusions
Low-dose aspirin does not protect against future cardiovascular events in VA patients, even patients who combine with minimal coronary artery stenosis.

Citations

Citations to this article as recorded by

Characteristics of Patients with Vasospastic Angina in Korea: Data from a Large Cohort (VA-KOREA)
Sung Eun Kim, Sang-Ho Jo, Won-Woo Seo, Min-Ho Lee, Hyun-Jin Kim, Seong-Sik Cho, Kwan Yong Lee, Dong-Soo Kim, Tae-Hyun Yang, Sung-Ho Her, Seung Hwan Han, Byoung-Kwon Lee, Youngkeun Ahn, Seung-Woon Rha, Hyeon-Cheol Gwon, Dong-Ju Choi, Sang Hong Baek
Cardiovascular Prevention and Pharmacotherapy.2021; 3(3): 47. CrossRef
Welcome to the New JournalCardiovascular Prevention and Pharmacotherapy
Mi-Jeong Kim, Jang-Whan Bae, Dae Ryong Kang
Cardiovascular Prevention and Pharmacotherapy.2019; 1(1): 1. CrossRef

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