Introduction: Cardiac arrest is a lethal complication in patients with vasospastic angina (VSA). Although VSA patients responding to vasodilator therapy have a good prognosis, the long-term clinical outcome of VSA patients presenting with aborted sudden cardiac arrest (SCA) is still controversial.
Hypothesis: The prognosis of VSA patients who survived from sudden cardiac arrest might be poor.
Methods: 1,157 VSA patients diagnosed by coronary angiography with ergonovine provocation test were analyzed. Major adverse cardiovascular events were a composite outcome of cardiac death, acute myocardial infarction, coronary revascularization, and rehospitalization for recurrent angina.
Results: Aborted sudden cardiac arrest occurred in 39 (3.4%) patients. The aborted SCA group had significantly higher risk of recurrent myocardial infarction (12.8% versus 5.8%, HR 3.26, 95% CI 1.31 - 8.12, p = 0.01), as well as major adverse cardiovascular events (28.2% versus 21.6%, HR 1.97, 95% CI 1.08 - 3.61, p = 0.03). Significant organic stenosis, use of nitrates or aspirin, and ventricular tachycardia or fibrillation were significantly associated with major adverse cardiovascular events.
Conclusions: VSA patients survived from SCA had a higher risk of adverse clinical outcomes. In addition, significant organic stenosis, use of nitrates or aspirin, and ventricular tachycardia or fibrillation were adverse prognostic factors for major adverse cardiovascular events of VSA patients.