Variant Angina Pectoris Role of Coronary Spasm in the Development of Fixed Coronaiy Obstructions

Background. It has been suggested that recurring coronary artery spasm may lead to the development of fixed atherosclerotic coronary obstructions. Methods and Results. We studied 10 patients with typical Prinzmetal's variant angina in whom the disease remained active for years and in whom occlusive coronary spasm occurred reproducibly at the same arterial site during repeat coronary arteriography (25+12 months after initial angiography). At initial evaluation, four patients had significant (>50%N fixed coronary diameter reduction) one-vessel coronary artery disease, and six had nonsignificant disease. Spasm developed at stenotic sites (20-65% diameter reduction) in nine patients and at