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Original article
Available online 1 April 2026
Predictors of sudden cardiac arrest in vasospastic angina
Predictores de paro cardiaco súbito en angina vasoespástica
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Albert Ariza-Solé
Corresponding author
aariza@bellvitgehospital.cat

Corresponding author.
, Chaima Zoljami Aidoun
Servicio de Cardiología, Hospital Universitari de Bellvitge, Universitat de Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain
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Abstract
Introduction and objectives

Vasospastic angina (VSA) is a type of angina caused by spontaneous coronary spasms, which can result in ischemic episodes with serious complications such as sudden cardiac arrest (SCA). Although these events may be considered rare in the context of VSA, they are not uncommon and might be life-threatening. The primary objective of this study is to identify potential predictive factors of SCA in patients admitted for VSA.

Methods

A retrospective observational study was conducted at Bellvitge University Hospital in Catalonia. A total of 150 patients diagnosed with VSA between January 2010 and February 2022 were included. The primary endpoint was the occurrence of SCA during the follow-up period. The cohort was stratified into 2 groups to assess differences between patients who experienced SCA and those who did not.

Results

At the end of the follow-up, 10 patients suffered an SCA (6.67%). The final multivariant model showed that a higher likelihood of SCA was associated with chest pain at rest, cocaine consumption, and a low left ventricular ejection fraction. The model's area under the curve was 0.872. The mortality rate in patients with SCA was 30%.

Conclusions

Although uncommon, episodes of SCA in patients with VSA are not infrequent and carry a significant mortality rate. These events are more likely to occur in patients with cocaine consumption, those experiencing chest pain at rest, and those with a lower ejection fraction during their initial admission for VSA.

Keywords:
Vasospastic angina
Sudden cardiac arrest
Ejection fraction
Rest chest pain
Cocaine
Abbreviations:
LAD
LVEF
SCA
VA
VSA
Resumen
Introducción y objetivos

La angina vasoespástica (AVS) es un tipo de angina causada por espasmos coronarios espontáneos, que pueden resultar en episodios isquémicos con complicaciones graves como el paro cardiaco súbito (PCS). Aunque estos eventos pueden considerarse raros en el contexto de AVS, no son infrecuentes y pueden poner en peligro la vida del paciente. El objetivo principal de este estudio es identificar posibles factores predictivos de PCS en pacientes ingresados por AVS.

Métodos

Se realizó un estudio observacional retrospectivo en el Hospital Universitario de Bellvitge en Cataluña. Se incluyó a 150 pacientes diagnosticados con AVS desde enero de 2010 hasta febrero de 2022. El evento primario fue la ocurrencia del PCS durante el seguimiento. Se estratificó la cohorte en 2 grupos para evaluar las diferencias entre los pacientes que sufrieron PCS y los que no.

Resultados

Al final del seguimiento, 10 pacientes sufrieron un PCS (6,67%). En el modelo multivariante final se asociaron a una mayor probabilidad de PCS: dolor torácico en reposo, consumo de cocaína y baja fracción de eyección del ventrículo izquierdo. El área bajo la curva del modelo fue de 0,872. La mortalidad en pacientes con PCS fue del 30%.

Conclusiones

Los episodios de PCS en pacientes con AVS no son infrecuentes y conllevan una tasa de mortalidad significativa. Estos eventos son más probables en pacientes que consumen cocaína, aquellos con dolor torácico en reposo y aquellos con una fracción de eyección más baja durante su primer ingreso por AVS.

Palabras clave:
Angina vasoespástica
Paro cardiaco súbito
Fracción de eyección
Dolor torácico en reposo
Cocaína

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