There is no clear consensus on the potential efficacy and indications for sympathectomy to prevent recurrence of vasospasm in patients with refractory coronary artery spasm (CAS).
To compare the clinical outcomes of sympathectomy with those of conventional treatment in patients with refractory CAS.
Patients with refractory CAS were randomly assigned to sympathectomy group (n=37) or conventional treatment group (n=42). The primary end point was a composite of major adverse cardiac event (MACE) episodes (including cardiac death, nonfatal myocardial infarction, unstable angina, heart failure, and life-threatening arrhythmia), and the secondary end point was death from any cause within 24 months after randomization.
During the follow-up period of 24 months, the incidence of MACE in the sympathectomy and conventional treatment groups was 16.22 and 61.90%, respectively (P=0.0001). All-cause death as the secondary end point occurred in zero and six (14.29%) patients, respectively (P=0.0272). The Kaplan–Meier curve for MACE and all-cause death showed a significant between-group difference (log-rank test, P=0.0013 and 0.0176, respectively).
Compared with conventional treatment, sympathectomy significantly reduced the composite end point of MACE episodes and death from any cause in patients with refractory CAS by effectively preventing recurrence of vasospasm.
aDepartment of Cardiology, Shenzhen People’s Hospital, 2nd Clinical Medical College of Jinan University, First Affiliated Hospital of South University of Science and Technology, Shenzhen
bDepartment of Cardiology, Guangdong General Hospital, Guangdong Academy of Sciences, Guangzhou, People’s Republic of China
* Yaowang Lin and Huadong Liu contributed equally to the writing of this article.
Correspondence to Shaohong Dong, MD, Department of Cardiology, Shenzhen People’s Hospital, 2nd Clinical Medical College of Jinan University, First Affiliated Hospital of South University of Science and Technology, Shenzhen, Guangdong 518020, People’s Republic of China Tel: +86 202 274 3200; fax: +86 202 274 3200; e-mail: email@example.com
Received October 17, 2018
Received in revised form January 23, 2019
Accepted February 24, 2019