Skip to main content
NCBI home page
British Heart Journal logoLink to British Heart Journal
. 1986 Oct;56(4):341–345. doi: 10.1136/hrt.56.4.341

Influence of a variant angina on the results of percutaneous transluminal coronary angioplasty.

F Leisch, W Schützenberger, K Kerschner, W Herbinger
PMCID: PMC1236868  PMID: 2945575

Abstract

Nineteen (86%) of 22 patients with variant angina and important coronary stenoses (greater than 60%) had successful percutaneous transluminal coronary angioplasty. The acute complications in two patients were not caused by coronary spasms but by dissection with disturbance of perfusion. One of these two patients required a coronary bypass graft; the other was treated conservatively. Myocardial infarction developed in both patients. Despite long term administration of nifedipine (30-80 mg daily), restenoses occurred within six months (on average after 10 weeks) in nine patients with symptoms and one without. In four patients the restenoses exceeded the degree of stenosis before angioplasty. Five patients were revascularised by surgical means. Vessels in three out of four patients were later successfully dilated. After a mean period of observation of 24 months (6-51 months) 18 of the 19 patients are symptom free and do not require medication. The results confirm that angioplasty is an effective method of treating patients with variant angina and important coronary stenoses. The problem of the high frequency of restenosis, however, remains unresolved.

Full text

PDF
341

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Antman E., Muller J., Goldberg S., MacAlpin R., Rubenfire M., Tabatznik B., Liang C. S., Heupler F., Achuff S., Reichek N. Nifedipine therapy for coronary-artery spasm. Experience in 127 patients. N Engl J Med. 1980 Jun 5;302(23):1269–1273. doi: 10.1056/NEJM198006053022301. [DOI] [PubMed] [Google Scholar]
  2. Bentivoglio L. G., Leo L. R., Wolf N. M., Meister S. G. Frequency and importance of unprovoked coronary spasm in patients with angina pectoris undergoing percutaneous transluminal coronary angioplasty. Am J Cardiol. 1983 Apr;51(7):1067–1071. doi: 10.1016/0002-9149(83)90346-6. [DOI] [PubMed] [Google Scholar]
  3. Bertrand M. E., Lablanche J. M., Tilmant P. Y. Treatment of Prinzmetal's variant angina. Role of medical treatment with nifedipine and surgical coronary revascularization combined with plexectomy. Am J Cardiol. 1981 Jan;47(1):174–178. doi: 10.1016/0002-9149(81)90306-4. [DOI] [PubMed] [Google Scholar]
  4. Betriu A., Solignac A., Bourassa M. G. The variant form of angina: diagnostic and therapeutic implications. Am Heart J. 1974 Mar;87(3):272–278. doi: 10.1016/0002-8703(74)90063-5. [DOI] [PubMed] [Google Scholar]
  5. Corcos T., David P. R., Bourassa M. G., Val P. G., Robert J., Mata L. A., Waters D. D. Percutaneous transluminal coronary angioplasty for the treatment of variant angina. J Am Coll Cardiol. 1985 May;5(5):1046–1054. doi: 10.1016/s0735-1097(85)80004-8. [DOI] [PubMed] [Google Scholar]
  6. Corcos T., David P. R., Val P. G., Renkin J., Dangoisse V., Rapold H. G., Bourassa M. G. Failure of diltiazem to prevent restenosis after percutaneous transluminal coronary angioplasty. Am Heart J. 1985 May;109(5 Pt 1):926–931. doi: 10.1016/0002-8703(85)90231-5. [DOI] [PubMed] [Google Scholar]
  7. David P. R., Waters D. D., Scholl J. M., Crépeau J., Szlachcic J., Lespérance J., Hudon G., Bourassa M. G. Percutaneous transluminal coronary angioplasty in patients with variant angina. Circulation. 1982 Oct;66(4):695–702. doi: 10.1161/01.cir.66.4.695. [DOI] [PubMed] [Google Scholar]
  8. Gaasch W. H., Lufschanowski R., Leachman R. D., Alexander J. K. Surgical management of Prinzmetal's variant angina. Chest. 1974 Dec;66(6):614–621. doi: 10.1378/chest.66.6.614. [DOI] [PubMed] [Google Scholar]
  9. Grüntzig A. R., Senning A., Siegenthaler W. E. Nonoperative dilatation of coronary-artery stenosis: percutaneous transluminal coronary angioplasty. N Engl J Med. 1979 Jul 12;301(2):61–68. doi: 10.1056/NEJM197907123010201. [DOI] [PubMed] [Google Scholar]
  10. Hillis L. D., Braunwald E. Coronary-artery spasm. N Engl J Med. 1978 Sep 28;299(13):695–702. doi: 10.1056/NEJM197809282991305. [DOI] [PubMed] [Google Scholar]
  11. Hollman J., Austin G. E., Gruentzig A. R., Douglas J. S., Jr, King S. B., 3rd Coronary artery spasm at the site of angioplasty in the first 2 months after successful percutaneous transluminal coronary angioplasty. J Am Coll Cardiol. 1983 Dec;2(6):1039–1045. doi: 10.1016/s0735-1097(83)80327-1. [DOI] [PubMed] [Google Scholar]
  12. Kaltenbach M., Kober G., Scherer D., Vallbracht C. Recurrence rate after successful coronary angioplasty. Eur Heart J. 1985 Mar;6(3):276–281. doi: 10.1093/oxfordjournals.eurheartj.a061852. [DOI] [PubMed] [Google Scholar]
  13. Kent K. M., Bentivoglio L. G., Block P. C., Cowley M. J., Dorros G., Gosselin A. J., Gruntzig A., Myler R. K., Simpson J., Stertzer S. H. Percutaneous transluminal coronary angioplasty: report from the Registry of the National Heart, Lung, and Blood Institute. Am J Cardiol. 1982 Jun;49(8):2011–2020. doi: 10.1016/0002-9149(82)90223-5. [DOI] [PubMed] [Google Scholar]
  14. Leisch F., Herbinger W., Brücke P. Role of percutaneous transluminal coronary angioplasty in patients with variant angina and coexistent coronary stenosis refractory to maximal medical therapy. Clin Cardiol. 1984 Dec;7(12):654–659. doi: 10.1002/clc.4960071206. [DOI] [PubMed] [Google Scholar]
  15. Leisch F., Schützenberger W., Bergmann H., Jr, Kramar R., Herbinger W. Variant-Angina. Nicht-invasive Parameter zur Erkennung der Koronarmorphologie. Dtsch Med Wochenschr. 1982 Dec 17;107(50):1914–1918. doi: 10.1055/s-2008-1070232. [DOI] [PubMed] [Google Scholar]
  16. Levy R. I., Mock M. B., Willman V. I., Frommer P. L. Percutaneous transluminal coronary angioplasty. N Engl J Med. 1979 Jul 12;301(2):101–103. doi: 10.1056/NEJM197907123010209. [DOI] [PubMed] [Google Scholar]
  17. MacAlpin R. N. Contribution of dynamic vascular wall thickening to luminal narrowing during coronary arterial constriction. Circulation. 1980 Feb;61(2):296–301. doi: 10.1161/01.cir.61.2.296. [DOI] [PubMed] [Google Scholar]
  18. Maseri A., Severi S., Nes M. D., L'Abbate A., Chierchia S., Marzilli M., Ballestra A. M., Parodi O., Biagini A., Distante A. "Variant" angina: one aspect of a continuous spectrum of vasospastic myocardial ischemia. Pathogenetic mechanisms, estimated incidence and clinical and coronary arteriographic findings in 138 patients. Am J Cardiol. 1978 Dec;42(6):1019–1035. doi: 10.1016/0002-9149(78)90691-4. [DOI] [PubMed] [Google Scholar]
  19. Meier B., Gruentzig A. R., Goebel N., Pyle R., von Gosslar W., Schlumpf M. Assessment of stenoses in coronary angioplasty. Inter- and intraobserver variability. Int J Cardiol. 1983 May;3(2):159–169. doi: 10.1016/0167-5273(83)90032-3. [DOI] [PubMed] [Google Scholar]
  20. PRINZMETAL M., KENNAMER R., MERLISS R., WADA T., BOR N. Angina pectoris. I. A variant form of angina pectoris; preliminary report. Am J Med. 1959 Sep;27:375–388. doi: 10.1016/0002-9343(59)90003-8. [DOI] [PubMed] [Google Scholar]
  21. Rafflenbeul W., Lichtlen P. R. Zum Konzept der "dynamischen" Koronarstenose. Z Kardiol. 1982 Jul;71(7):439–444. [PubMed] [Google Scholar]
  22. Salerno D. M., Granrud G., Sharkey P., Asinger R., Hodges M. A controlled trial of propafenone for treatment of frequent and repetitive ventricular premature complexes. Am J Cardiol. 1984 Jan 1;53(1):77–83. doi: 10.1016/0002-9149(84)90687-8. [DOI] [PubMed] [Google Scholar]
  23. Severi S., Davies G., Maseri A., Marzullo P., L'Abbate A. Long-term prognosis of "variant" angina with medical treatment. Am J Cardiol. 1980 Aug;46(2):226–232. doi: 10.1016/0002-9149(80)90062-4. [DOI] [PubMed] [Google Scholar]
  24. Shubrooks S. J., Jr, Bete J. M., Hutter A. M., Jr, Block P. C., Buckley M. J., Daggett W. M., Mundth E. D. Variant angina pectoris: Clinical and anatomic spectrum and results of coronary bypass surgery. Am J Cardiol. 1975 Aug;36(2):142–147. doi: 10.1016/0002-9149(75)90517-2. [DOI] [PubMed] [Google Scholar]
  25. Waters D. D., Bouchard A., Théroux P. Spontaneous remission is a frequent outcome of variant angina. J Am Coll Cardiol. 1983 Aug;2(2):195–199. doi: 10.1016/s0735-1097(83)80153-3. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES