Coronary Spasm is Associated With Chronic Low-Grade Inflammation

• Published in: Circulation Journal Vol. 71; no. 7; pp. 1074 - 1078
• Main Authors: Harada, Eisaku, Ogawa, Hisao, Itoh, Teruhiko, Mizuno, Yuji, Yoshimura, Michihiro, Yasue, Hirofumi
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 2007
• Subjects: Acetylcholine; Aged; Biomarkers - blood; C-reactive protein; C-Reactive Protein - metabolism; Case-Control Studies; Chest Pain - drug therapy; Chronic Disease; Coronary spasm; Coronary Vasospasm - blood; Coronary Vasospasm - chemically induced; Coronary Vasospasm - etiology; Endothelial dysfunction; Female; Humans; Inflammation; Inflammation - blood; Inflammation - complications; Male; Middle Aged; Multivariate Analysis; Nitroglycerin - therapeutic use; Risk Factors; Sensitivity and Specificity; Smoking; Vasodilator Agents - therapeutic use
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.71.1074

Background Coronary spasm plays an important role in the pathogenesis of ischemic heart disease and it may be associated with low-grade inflammation. Methods and Results Intracoronary injection of acetylcholine was done in 199 patients (99 men, 100 women, mean age, 64.5±11.0 years) with chest pain and normal coronary angiograms. According to the results of the provocation test, the study subjects were divided into 2 groups: the spasm group of 112 patients and the non-spasm group of 87 patients. Clinical data including high-sensitivity C-reactive protein (hs-CRP) and other coronary risk factors were compared between the 2 groups. Serum levels of hs-CRP were significantly higher in the spasm group than in the non-spasm group (median: 1.2 mg/L vs 0.5 mg/L, p<0.005). Multivariate analysis showed that hs-CRP and smoking history were independently associated with coronary spasm with an odds ratio of 2.28 (p=0.027) and 2.25 (p=0.037), respectively, with a hs-CRP value of ≥2 mg/L as cutoff point. Conclusions Minor elevations of the serum hs-CRP level are significantly associated with coronary spasm, suggesting that chronic low-grade inflammation may be involved in the pathogenesis of coronary spasm. (Circ J 2007; 71: 1074 - 1078)