Unveiling Phenotypic Heterogeneity in Coronary Spastic Angina Through Multidimensional Risk Profiling: The FUJI-SPASM Study
Authors' conclusion
CSA comprises distinct metabolic and inflammatory phenotypes with differing determinants of coronary spasm and endothelial dysfunction. Reduced HDL-C represents a shared vulnerability across phenotypes, while inflammation confers additional risk. HDL-C/hs-CRP-based stratification provides a clinically accessible framework for individualized CSA risk assessment.
Study context
- Population
- Patients with suspected coronary spastic angina (CSA) and no obstructive coronary artery disease from the FUJI-SPASM registryEndothelial function assessed by flow-mediated dilation in a subset of 159 patients
- Participants
- 568 patients
- Exposure
- Cluster 0 vs cluster 1
- Cluster 0n = 231
- Cluster 1n = 337
- Outcome
- Phenotypes identified
Methodological detailsunsupervised k-means clustering, adaptive least absolute shrinkage and selection operator regression followed by multivariable logistic regression
- Unsupervised k-means clustering
- Adaptive least absolute shrinkage and selection operator regression followed by multivariable logistic regression
Main finding
As reported in the abstract
- Two phenotypes were identified
Observational data: associations, not effects.
Further findings
Determinants of coronary spasm
- Lower high-density lipoprotein cholesterol (HDL-C) was associated with coronary spasm in both clusters
- Higher high-sensitivity C-reactive protein (hs-CRP) was independently associated with spasm only in the inflammation-dominant cluster
HDL-C/hs-CRP-based stratification
- Graded increase in spasm prevalence and worsening endothelial function
Original publication
Unveiling Phenotypic Heterogeneity in Coronary Spastic Angina Through Multidimensional Risk Profiling: The FUJI-SPASM Study. JACC Adv. Published March 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →