Takagi et al reported a prognostic score for a patient with vasospastic angina. This can help to identify a patient who may benefit from more aggressive management. The authors are from multiple institutions in Japan and are members of the Japanese Coronary Spasm Association.
Patient selection: vasospastic angina (VSA)
Parameters:
(1) smoker
(2) angina at rest alone
(3) ST segment elevation during an angina attack
(4) history of out-of-hospital cardiac arrest (OHCA)
(5) significant organic stenosis
(6) multi-vessel spasm
(7) therapy with a beta-blocker
Parameter
Finding
Points
smoker
no
0
yes
2
angina at rest alone
no
0
yes
2
ST segment elevation
no
0
yes
1
history of OHCA
no
0
yes
4
significant organic stenosis
no
0
yes
2
multi-vessel spasm
no
0
yes
2
therapy with beta-blocker
no
0
yes
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 14
• The higher the score the greater the risk for major adverse cardiac event (MACE).
Score
Risk Group
MACE
Hard MACE
0 to 2
low
2.5%
0.5%
3 to 5
intermediate
7%
0.8%
6 to 14
high
13%
3.1%
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