Repurposing Riociguat for Treatment of Refractory Angina Resulting From Coronary Spasm

Valeria Martínez Pereyra; Andreas Seitz; Astrid Hubert; Sascha Beck; Ute Hofmann; Matthias Schwab; Raffi Bekeredjian; Udo Sechtem; Peter Ong

doi:10.1016/j.jaccas.2020.11.043

Repurposing Riociguat for Treatment of Refractory Angina Resulting From Coronary Spasm

JACC Case Rep. 2021 Feb 24;3(3):392-396. doi: 10.1016/j.jaccas.2020.11.043. eCollection 2021 Mar.

Authors

Affiliations

¹ Department of Cardiology, Robert-Bosch-Hospital, Stuttgart, Germany.
² Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart and University of Tübingen, Germany.
³ Department of Clinical Pharmacology, University of Tübingen, Tübingen, Germany.
⁴ Department of Pharmacy and Biochemistry, University of Tübingen, Tübingen, Germany.

Abstract

Coronary spasm is a frequent cause of angina despite unobstructed coronary arteries, and symptom control with recommended drugs is limited. We report the case of a 77-year-old woman who had refractory angina despite conventional antianginal treatment. Repurposing riociguat, a soluble guanylate cyclase stimulator, resulted in improvement of symptoms and prevention of spasm. (Level of Difficulty: Intermediate.).

Keywords: ACh, acetylcholine; ECG, electrocardiogram; LCx, left circumflex artery; acetylcholine testing; coronary artery spasm; drug repurposing; individual treatment trial; microvascular dysfunction; riociguat; sGC, soluble guanylate cyclase; soluble guanylate cyclase.

Publication types

Case Reports