![]() Epicardial spasm was prevalent in 43% (range 16–73%), with a higher prevalence in Asian vs. Percentages of epicardial constriction to define epicardial spasm ranged from >50% to >90%. Results: Twenty-five publications ( N = 14.554) were included (58.2 years 44.2% women). Data, except for prognosis were pooled and analysed using random effects meta-analysis models. Multiple outcomes (prevalence, clinical features, and prognosis) were assessed. Methods: A systematic review identifying studies describing ANOCA patients with CAS was performed. This review provides a structured overview of the prevalence, characterization and prognosis of CAS worldwide in men and women. However, various spasm provocation testing protocols and diagnostic criteria are used, making diagnosis and characterization of these patients difficult and interpretation of study results cumbersome. ![]() 6Department of Cardiology, Robert Bosch Hospital, Stuttgart, Germanyīackground: Coronary artery spasm (CAS), encompassing epicardial and microvascular spasm, is increasingly recognized as cause of angina in patients with non-obstructive coronary artery disease (ANOCA).5Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC Location University of Amsterdam, Amsterdam, Netherlands.4Department of Physiology, Maastricht University, Cardiovascular Research Institute Maastricht, Maastricht, Netherlands.3Department of Physiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands.2Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.1Department of Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands. ![]() de Waard 1, Peter Ong 6, Andreas Seitz 6, Udo Sechtem 6, Jan J.
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