Repurposing Riociguat for Treatment of Refractory Angina Resulting From Coronary Spasm

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

• acetylcholine testing
• coronary artery spasm
• drug repurposing
• individual treatment trial
• microvascular dysfunction
• riociguat