Association Between Coronary Artery Spasm and Atherosclerotic Disease

Denise Peeters; Eva Woelders; Tijn Jansen; Regina Konst; Caïa Crooijmans; Tim van de Hoef; Frans Mensink; Jonathan Los; Dario Pellegrini; Jan Hein Cornel; Peter Ong; Niels van Royen; Aukelien Leen; Suzette Elias-Smale; Robert Jan van Geuns; Peter Damman

doi:10.1016/j.jcmg.2024.05.024

Association Between Coronary Artery Spasm and Atherosclerotic Disease

Denise Peeters, Eva Woelders, Tijn Jansen, Regina Konst, Caïa Crooijmans, Tim van de Hoef, Frans Mensink, Jonathan Los, Dario Pellegrini, Jan Hein Cornel, Peter Ong, Niels van Royen, Aukelien Leen, Suzette Elias-Smale, Robert Jan van Geuns, Peter Damman^*

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

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Abstract

In at least one-half of the patients with angina or ischemia and nonobstructive coronary arteries undergoing coronary function testing, coronary artery spasm (CAS) is detected. CAS is associated with an adverse prognosis regarding recurrent complaints and ischemic events. Current treatment options are mainly focused on the complaints, not on the underlying pathophysiological process. In this review we discuss available evidence regarding the presence, amount, and morphology of atherosclerosis in CAS patients. The reviewed evidence confirmed that atherosclerosis and vulnerable plaque characteristics are often detected in patients with CAS. The amount of atherosclerosis is higher in patients with focal CAS compared with patients with diffuse CAS. Severity of atherosclerosis is associated with the presence of CAS and the prognosis in CAS patients with atherosclerotic stenosis is worse. Therefore, CAS patients with atherosclerosis might benefit from targeted atherosclerotic treatment. Longitudinal studies are needed to elucidate the exact relation between atherosclerosis and CAS.

Original language	English
Pages (from-to)	226-239
Number of pages	14
Journal	JACC: Cardiovascular Imaging
Volume	18
Issue number	2
Early online date	7 Aug 2024
DOIs	https://doi.org/10.1016/j.jcmg.2024.05.024
Publication status	Published - Feb 2025

Keywords

atherosclerosis
coronary spasm
prognosis
treatment

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10.1016/j.jcmg.2024.05.024Licence: CC BY

1-s2.0-S1936878X24002468-mainFinal published version, 1.87 MBLicence: CC BY

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Peeters, D., Woelders, E., Jansen, T., Konst, R., Crooijmans, C., van de Hoef, T., Mensink, F., Los, J., Pellegrini, D., Cornel, J. H., Ong, P., van Royen, N., Leen, A., Elias-Smale, S., van Geuns, R. J., & Damman, P. (2025). Association Between Coronary Artery Spasm and Atherosclerotic Disease. JACC: Cardiovascular Imaging, 18(2), 226-239. https://doi.org/10.1016/j.jcmg.2024.05.024

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title = "Association Between Coronary Artery Spasm and Atherosclerotic Disease",

abstract = "In at least one-half of the patients with angina or ischemia and nonobstructive coronary arteries undergoing coronary function testing, coronary artery spasm (CAS) is detected. CAS is associated with an adverse prognosis regarding recurrent complaints and ischemic events. Current treatment options are mainly focused on the complaints, not on the underlying pathophysiological process. In this review we discuss available evidence regarding the presence, amount, and morphology of atherosclerosis in CAS patients. The reviewed evidence confirmed that atherosclerosis and vulnerable plaque characteristics are often detected in patients with CAS. The amount of atherosclerosis is higher in patients with focal CAS compared with patients with diffuse CAS. Severity of atherosclerosis is associated with the presence of CAS and the prognosis in CAS patients with atherosclerotic stenosis is worse. Therefore, CAS patients with atherosclerosis might benefit from targeted atherosclerotic treatment. Longitudinal studies are needed to elucidate the exact relation between atherosclerosis and CAS.",

keywords = "atherosclerosis, coronary spasm, prognosis, treatment",

author = "Denise Peeters and Eva Woelders and Tijn Jansen and Regina Konst and Ca{\"i}a Crooijmans and {van de Hoef}, Tim and Frans Mensink and Jonathan Los and Dario Pellegrini and Cornel, {Jan Hein} and Peter Ong and {van Royen}, Niels and Aukelien Leen and Suzette Elias-Smale and {van Geuns}, {Robert Jan} and Peter Damman",

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doi = "10.1016/j.jcmg.2024.05.024",

language = "English",

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Peeters, D, Woelders, E, Jansen, T, Konst, R, Crooijmans, C, van de Hoef, T, Mensink, F, Los, J, Pellegrini, D, Cornel, JH, Ong, P, van Royen, N, Leen, A, Elias-Smale, S, van Geuns, RJ & Damman, P 2025, 'Association Between Coronary Artery Spasm and Atherosclerotic Disease', JACC: Cardiovascular Imaging, vol. 18, no. 2, pp. 226-239. https://doi.org/10.1016/j.jcmg.2024.05.024

TY - JOUR

T1 - Association Between Coronary Artery Spasm and Atherosclerotic Disease

AU - Peeters, Denise

AU - Woelders, Eva

AU - Jansen, Tijn

AU - Konst, Regina

AU - Crooijmans, Caïa

AU - van de Hoef, Tim

AU - Mensink, Frans

AU - Los, Jonathan

AU - Pellegrini, Dario

AU - Cornel, Jan Hein

AU - Ong, Peter

AU - van Royen, Niels

AU - Leen, Aukelien

AU - Elias-Smale, Suzette

AU - van Geuns, Robert Jan

AU - Damman, Peter

PY - 2025/2

Y1 - 2025/2

N2 - In at least one-half of the patients with angina or ischemia and nonobstructive coronary arteries undergoing coronary function testing, coronary artery spasm (CAS) is detected. CAS is associated with an adverse prognosis regarding recurrent complaints and ischemic events. Current treatment options are mainly focused on the complaints, not on the underlying pathophysiological process. In this review we discuss available evidence regarding the presence, amount, and morphology of atherosclerosis in CAS patients. The reviewed evidence confirmed that atherosclerosis and vulnerable plaque characteristics are often detected in patients with CAS. The amount of atherosclerosis is higher in patients with focal CAS compared with patients with diffuse CAS. Severity of atherosclerosis is associated with the presence of CAS and the prognosis in CAS patients with atherosclerotic stenosis is worse. Therefore, CAS patients with atherosclerosis might benefit from targeted atherosclerotic treatment. Longitudinal studies are needed to elucidate the exact relation between atherosclerosis and CAS.

AB - In at least one-half of the patients with angina or ischemia and nonobstructive coronary arteries undergoing coronary function testing, coronary artery spasm (CAS) is detected. CAS is associated with an adverse prognosis regarding recurrent complaints and ischemic events. Current treatment options are mainly focused on the complaints, not on the underlying pathophysiological process. In this review we discuss available evidence regarding the presence, amount, and morphology of atherosclerosis in CAS patients. The reviewed evidence confirmed that atherosclerosis and vulnerable plaque characteristics are often detected in patients with CAS. The amount of atherosclerosis is higher in patients with focal CAS compared with patients with diffuse CAS. Severity of atherosclerosis is associated with the presence of CAS and the prognosis in CAS patients with atherosclerotic stenosis is worse. Therefore, CAS patients with atherosclerosis might benefit from targeted atherosclerotic treatment. Longitudinal studies are needed to elucidate the exact relation between atherosclerosis and CAS.

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KW - coronary spasm

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SN - 1936-878X

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SP - 226

EP - 239

JO - JACC: Cardiovascular Imaging

JF - JACC: Cardiovascular Imaging

IS - 2

ER -

Association Between Coronary Artery Spasm and Atherosclerotic Disease

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