Statins are one of the most widely used drugs worldwide as first-line drugs for the treatment of hyperlipidemia and the prevention and treatment of cardiovascular diseases. Most of the side effects of statins are known to be mild, and mainly hepatotoxicity and various muscle symptoms are known. Recently, there have been studies on concerns about an increase in the incidence of diabetes after using statins, but it was found that the benefits sufficiently outweigh the risk of side effects. Therefore, the use of statins in the appropriate group should be actively performed, and it seems that the side effects can be prevented through close physical observation and appropriate examination.
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The Variant Angina Korea (VA-KOREA) registry is a nationwide prospective multicenter registry designed to reflect the real-world clinical data of Korean patients with vasospastic angina (VSA). A total of 2,960 patients with chest pain and presumed VSA who underwent coronary angiography (CAG) and an ergonovine provocation test were enrolled. The primary endpoint composite of death from any cause, acute coronary syndrome, and newonset symptomatic arrhythmia during the 3-year follow-up was investigated for patient characteristics, laboratory findings, CAG findings, and medications. This article reviewed the current status of VSA in Korea and new findings from VA-KOREA registries to improve the treatment and prognosis of patients with VSA.
Background The aim of this multi-center prospective registry study was to evaluate the clinical efficacy of low-dose aspirin in vasospastic angina (VA) patients for the prevention of future cardiovascular events.
Methods A total of 1,717 patients with positive and intermediate results of an intracoronary ergonovine provocation test in the VA in Korea registry (n=2,960) were classified into 100 mg/day aspirin intake (aspirin, n=743) and no-aspirin intake (control, n=974) groups. The primary end-point was a composite of major adverse cardiac events (MACEs) including cardiac death, new-onset arrhythmia, and acute coronary syndrome.
Results The median follow-up duration was 2.0 years (25–75th, interquartile range 0.9–3.0 years). Cumulative composite MACE in the propensity score matched-pair cohort (n=1,028) was 3.6%. There was no significant difference in composite MACE between the aspirin and control groups (3.1% vs. 4.1%; hazard ratio [HR], 1.18; 95% confidence interval [CI], 0.61–2.26; p=0.623). A sensitivity analysis of only the VA-positive population showed these results to be consistent. Even for patients with minimal organic stenosis (n=369), aspirin usage was not related to the incidence of a composite MACE (HR, 1.61; 95% CI, 0.55–4.72; p=0.380).
Conclusions Low-dose aspirin does not protect against future cardiovascular events in VA patients, even patients who combine with minimal coronary artery stenosis.
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Characteristics of Patients with Vasospastic Angina in Korea: Data from a Large Cohort (VA-KOREA) Sung Eun Kim, Sang-Ho Jo, Won-Woo Seo, Min-Ho Lee, Hyun-Jin Kim, Seong-Sik Cho, Kwan Yong Lee, Dong-Soo Kim, Tae-Hyun Yang, Sung-Ho Her, Seung Hwan Han, Byoung-Kwon Lee, Youngkeun Ahn, Seung-Woon Rha, Hyeon-Cheol Gwon, Dong-Ju Choi, Sang Hong Baek Cardiovascular Prevention and Pharmacotherapy.2021; 3(3): 47. CrossRef
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