CT Predictors of Epicardial Coronary Spasm in Patients With Angina and Nonobstructive Coronary Arteries
Authors' conclusion
For patients with angina and nonobstructive coronary arteries, a prespasm provocation test using a noninvasive comprehensive assessment with CCTA may help identify those at high risk for VSA.
Study context
- Population
- Patients with angina and nonobstructive coronary arteries who underwent a spasm provocation test and CCTA within 3 months before the spasm provocation test55 (38.7%) diagnosed with vasospastic angina (VSA)
- Participants
- 142 patients
- Exposure
- Clinical and CCTA features in patients with vs without VSA
- VSAn = 55
- Outcome
- Male sex
Main finding
As reported in the abstract
- VSA vs No VSA: 74.5% versus 51.7%; P = 0.01
Observational data: associations, not effects.
Further findings
Multivariable association with VSA
| Odds ratio (95% CI) | P value | ||
|---|---|---|---|
| CCTA-defined MBIndependently associated with VSA | 2.23 (1.03–4.83) | P = 0.04 | |
| Presence of mixed or noncalcified plaqueIndependently associated with VSA | 3.15 (1.45–6.80) | P < 0.01 | |
| 0.10.31310Odds ratio (log scale) |
| Outcome | Odds ratio (95% CI) | P value | |
|---|---|---|---|
| Multivariable association with VSARight coronary artery-FAI 2mm · per unit · independently associated with VSA | 1.07 (1.02–1.12) | P < 0.01 | |
| 0.512Odds ratio (log scale) |
| Outcome | Estimate | P value |
|---|---|---|
| Smoking history | 70.9% versus 52.9% | P = 0.05 |
| CCTA-defined MB | 49.1% versus 28.7% | P = 0.02 |
| Right coronary artery-FAI 2mm | −68.8 Hounsfield unit versus −74.0 Hounsfield unit | P < 0.01 |
| Mixed or noncalcified plaque anywhere in the coronary tree | 65.5% versus 39.1% | P < 0.01 |
Prediction of VSA by combination of 3 factors
- All 3 factors (myocardial bridge (MB), high right coronary artery-FAI 2mm ≥−72.6 Hounsfield unit, mixed or noncalcified plaque) predicted VSA
- 75.0%
- Absence of all 3 factors precluded VSA
- 95.6%
Original publication
CT Predictors of Epicardial Coronary Spasm in Patients With Angina and Nonobstructive Coronary Arteries. Circ Cardiovasc Imaging. Published 21 March 2025. doi:10.
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