Increased Rate of Hospitalization With Prinzmetal Angina: What Exactly Is Happening?

We read with great interest the article by Elbadawi et al1 to the effect that substantial increases, both absolute and relative, have occurred in US hospitalizations for Prinzmetal angina from 2002 to 2015. The authors commented both that Prinzmetal angina is notoriously underdiagnosed and that the associated episodes of coronary artery spasm often require the use of provocative testing at the time of coronary angiography. They conclude that, subject to potential coding-based caveats, the prevalence of Prinzmetal angina has increased in the United States over the past 15 years.