Treatment of Coronary Artery Spasm

Coronary artery spasm plays a key role in a wide range of ischemic heart diseases not only in vasospastic angina (VSA) but also in acute coronary syndrome and sudden cardiac death in Asia and Western countries. In the era of widespread utilization of drug-eluting stents (DES) in the field of coronary intervention, it is important to realize the fact that patients still have unremitting angina symptoms even after resolving organic coronary stenosis with DES implantation. Although conventional management of VSA involves lifestyle modifications, use of established pharmacological therapies, further novel therapies need to be developed. Basic and clinical evidence also has been accumulated for elucidating the risk to predict future cardiovascular events, detailed mechanism of coronary artery spasm, which in turn, provides new therapeutic approach for coronary spasm. In this chapter, we will summarize the recent advances in the treatment of coronary artery spasm mainly based on our findings.