In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Impact of different nitrate therapies on long-term clinical outcomes of patients with vasospastic angina: a propensity score-matched analysis

Session Poster session 1

Speaker Seung-Hyuk Choi

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease (Chronic)
  • Session type : Poster Session

Authors : TK Park (Seoul,KR), JH Yang (Seoul,KR), YB Song (Seoul,KR), JY Hahn (Seoul,KR), JH Choi (Seoul,KR), SH Choi (Seoul,KR), SH Lee (Seoul,KR), HC Gwon (Seoul,KR)

Authors:
T.K. Park1 , J.H. Yang1 , Y.B. Song1 , J.Y. Hahn1 , J.H. Choi1 , S.H. Choi1 , S.H. Lee1 , H.C. Gwon1 , 1Samsung Medical Center, Division of Cardiology, Department of Medicine - Seoul - Korea Republic of ,

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 192

Background: Despite the short-term vasodilatory effects of nitrates, the prognostic effects of long-term nitrate therapy in patients with vasospastic angina (VSA) remains unclear.

Purpose: We investigated the prognostic impact of chronic nitrate therapy in VSA patients.

Methods: Between January 2003 and December 2014, a total of 1,154 VSA patients proven by ergonovine provocation tests were classified into nitrate (n=676) and non-nitrate (n=478) groups according to prescriptions for oral nitrates, including isosorbide mononitrate (ISMN) and nicorandil. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of cardiac death, myocardial infarction, any revascularization, or rehospitalization due to recurrent angina.

Results: The nitrate group was found to have a higher risk of MACE (22.9% vs. 17.6%, hazard ratio [HR] 1.32, 95% confidence interval [CI] 1.01–1.73, p=0.043) than the non-nitrate group. After propensity score matching, the nitrate group had greater risks of MACE (HR 1.32, 95% CI 1.01–1.73, p=0.049). Patients who received the immediate-release formula of ISMN (HR 1.66, 95% CI 1.23–2.23, p=0.001) or were administered any forms of ISMN other than at bedtime (HR 1.67, 95% CI 1.22–2.27, p=0.001) had a significantly higher risk of MACE compared with the non-nitrate group. Nicorandil was shown to have a neutral effect on VSA patients (HR 1.01, 95% CI 0.69–1.50, p=0.95).

Conclusion: The long-term use of nitrate therapy was associated with increased risk of adverse cardiac events in VSA patients. The use of immediate-release ISMN or the administration of ISMN other than at bedtime was related with poor outcomes of VSA patients.

Subgroup analysis for nitrate treatment

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are