OUTCOME OF VASOSPASTIC ANGINA WITH NORMAL OR NEAR-NORMAL CORONARY-ARTERIES

The outcome of vasospastic angina with normal or near-normal coronary arteries was investigated in 48 patients followed up for periods of 3 to 55 months (mean : 19.1 months). The course of the disease was unfavorable in 13 patients, of whom 3 died, 5 developed myocardial infarction and 5 refractory angina. It was favourable in 16 patients who remained asymptomatic for at least 6 months, and intermediate in 16 patients whose anginal attacks became less frequent. Three patients were lost sight of. Calcium antagonists were administered to 32 patients; they proved superior to beta-blockers but imperfectly controlled the course of the disease : the anginal attacks completely ceased in 12 patients, became less frequent in 11 and persisted or became worse in 5. A close correlation was found between long-term outcome and the results of provocation tests performed at the beginning of treatment, and it is proposed that these tests should be used as therapeutic guide-lines.