Impact of cigarette smoking: A 3-Year clinical outcome of vasospastic angina patients

Byoung Geol Choi, Seung Woon Rha, Taeshik Park, Se Yeon Choi, Jae Kyeong Byun, Min Suk Shim, Shaopeng Xu, Hu Li, Sang Ho Park, Ji Young Park, Woong Gil Choi, Yun Hyeong Cho, Sunki Lee, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Jin Won Kim, Eung Ju Kim, Chang Gyu Park, Hong Seog SeoDong Joo Oh

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Background and Objectives: Cigarette smoking is a risk significant factor in coronary artery disease (CAD) and vasospastic angina (VSA). However, it is largely unknown whether smoking adds to any long-Term clinical risk in VSA patients. Subjects and Methods: A total of 2797 patients without significant CAD underwent acetylcholine (Ach) provocation test between November 2004 and October 2010. Patients were divided into three groups, based on the presence of coronary artery spasm (CAS) and smoking habits (non-CAS group: n=1188, non-smoking CAS group: n=1214, smoking CAS group: n=395). All CAS patients were prescribed with anti-Anginal medications for at least 6 months. The incidence of major clinical outcomes and recurrent angina of these groups were compared up to 3 years. Results: There were considerable differences in the baseline clinical and angiographic characteristics among the three groups, but there was no difference in the endpoints among the three groups (including individual and composite hard endpoints) such as death, myocardial infarction, de novo percutaneous coronary intervention, cerebrovascular accident, and major adverse cardiac events. However, there was a higher incidence of recurrent angina in both the non-smoking CAS group and smoking CAS group, as compared to the non-CAS group. In multivariable adjusted Cox-proportional hazards regression analysis, smoking CAS group exhibited a higher incidence of recurrent angina compared with the non-CAS group (hazard ratio [HR]; 2.46, 95% confidence interval [CI]; 1.46-4.14, p=0.001) and nonsmoking CAS group (HR; 1.76, 95% CI; 1.08-2.87, p=0.021). Conclusion: Cigarette smoking CAS group exhibited higher incidence of recurrent angina during the 3-year clinical follow-up compared with both the non-CAS group and non-smoking CAS group. Quitting of smoking, paired with intensive medical therapy and close clinical follow-up, can help to prevent recurrent angina.

Original languageEnglish
Pages (from-to)632-638
Number of pages7
JournalKorean Circulation Journal
Issue number5
Publication statusPublished - 2016 Sept

Bibliographical note

Publisher Copyright:
© Copyright 2016 The Korean Society of Cardiology.


  • Cigarette smoking
  • Clinical outcome
  • Coronary artery spasm

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine


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