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A VSR is more likely to occur in patients who are older, female, hypertensive, have chronic kidneydisease, and have no prior history of smoking. It commonly occurs in the setting of a first myocardial infarction (MI) in the background of delayed or absent reperfusion therapy.
35 In a large multicenter double-blind randomized trial (LoDoCo2) involving 5,522 patients with clinically stable coronary artery disease, almost all of them on statin therapy, colchicine, 0.5 The benefit was most significant in reducing the incidence of stroke and angina requiring revascularization.35 12 Colchicine, 0.5 μ/L on 0.6
Denying patients the potential benefit of revascularization just because their symptoms have lasted a certain amount of time shows poor understanding of the pathophysiology of myocardial ischemia. There were no other causes of dyspnea apparent and thus we can assume that myocardial ischemia started 6 days prior.
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