Diffuse intimal thickening of coronary arteries in patients with coronary spastic angina

OBJECTIVES The purpose of this study was to evaluate the extent of atherosc lerotic changes in angiographically normal coronary arteries using intravas cular ultrasound (IVUS) technique in patients with coronary spastic angina. BACKGROUND Nitric oxide activity was shown to be decreased in coronary arte ries of patients with coronary spastic angina (CSA). Decrease in nitric oxi de causes arterial intimal hyperplasia or thickening. However, it remains u nclear whether intimal thickening is diffusely present in coronary arteries of patients with CSA. METHODS The IVUS study was performed in 26 patients with CSA and with. norm al coronary angiograms and in 31 control subjects in whom age and gender wa s matched with those in patients with CSA. RESULTS Compared with control subjects, patients with CSA had significantly larger percent intima + media area (%I + M area), intima + media area and maximal intima di media thickness in all of proximal, middle and distal seg ments (p < 0.01, respectively). Lumen area was comparable between these gro ups. The presence of spasm was the most powerful independent predictor of i ncrease in percent intima + media area, in multiple-regression analysis wit h the traditional risk factors as covariates. CONCLUSIONS Intimal thickening existed entirely in a coronary artery in pat ients with CSA and with normal angiograms, independently of other tradition al risk factors. The diffuse intimal thickening in the spasm coronary arter ies is intimately related with coronary spasm. (C) 2000 by the American Col lege of Cardiology.