Nitrates vs. Other Types of Vasodilators and Clinical Outcomes in Patients with Vasospastic Angina: A Propensity Score-Matched Analysisopen access
- Authors
- Kim, Hyun-Jin; Jo, Sang-Ho; Lee, Min-Ho; Seo, Won-Woo; Kim, Hack-Lyoung; Lee, Kwan Yong; Yang, Tae-Hyun; Her, Sung-Ho; Lee, Byoung-Kwon; Park, Keun-Ho; Ahn, Youngkeun; Rha, Seung-Woon; Gwon, Hyeon-Cheol; Choi, Dong-Ju; Baek, Sang Hong
- Issue Date
- Jun-2022
- Publisher
- MDPI
- Keywords
- vasospastic angina; nitrate; vasodilator; acute coronary syndrome
- Citation
- JOURNAL OF CLINICAL MEDICINE, v.11, no.12
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF CLINICAL MEDICINE
- Volume
- 11
- Number
- 12
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/143414
- DOI
- 10.3390/jcm11123250
- ISSN
- 2077-0383
- Abstract
- Although vasodilators are widely used in patients with vasospastic angina (VA), few studies have compared the long-term prognostic effects of different types of vasodilators. We investigated the long-term effects of vasodilators on clinical outcomes in VA patients according to the type of vasodilator used. Study data were obtained from a prospective multicenter registry that included patients who had symptoms suggestive of VA. Patients were classified into two groups according to use of nitrates (n = 239) or other vasodilators (n = 809) at discharge. The composite clinical events rate, including acute coronary syndrome (ACS), cardiac death, new-onset arrhythmia (including ventricular tachycardia and ventricular fibrillation), and atrioventricular block, was significantly higher in the nitrates group (5.3% vs. 2.2%, p = 0.026) during one year of follow-up. Specifically, the prevalence of ACS was significantly more frequent in the nitrates group (4.3% vs. 1.5%, p = 0.024). After propensity score matching, the adverse effects of nitrates remained. In addition, the use of nitrates at discharge was independently associated with a 2.69-fold increased risk of ACS in VA patients. In conclusion, using nitrates as a vasodilator at discharge can increase the adverse clinical outcomes in VA patients at one year of follow-up. Clinicians need to be aware of the prognostic value and consider prescribing other vasodilators.
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