Clinical Characteristics of Female Patients With Coronary Spastic Angina

Abstract

There are many patients with vasospastic angina who have minor atherosclerosis, and in Japan the majority of them are male. No data exist concerning sex differences in patients with coronary spastic angina, so the present study sought to clarify the clinical characteristics between male and female patients with vasospastic angina. Between April 1991 and June 1998, 204 consecutive patients were diagnosed with vasospastic angina and of these, 26 (12.7%) were female. An acetylcholine test was performed with incremental doses of 20, 50, and 80 microg injected into the right coronary artery and 20, 50, and 100 microg into the left coronary artery. Ergonovine was injected in a total dose of 40 microg into the right coronary artery and 64 microg into the left coronary artery. Coronary spasm was defined as 99% or more luminal narrowing accompanied by ischemic changes on ECG. Compared with male patients, female patients had less organic stenosis (12 vs 33%, p<0.05), less history of smoking (15 vs 85%, p<0.01), and fewer focal spasms (31 vs 64%, p<0.01). There were no other differences between the 2 groups. In conclusion, Japanese female patients with vasospastic angina had the characteristics of diffuse provoked spasm, less organic stenosis, and less history of smoking, but only 1 in 10 of all patients with vasospastic angina are female.

Gender Differences in the Clinical Characteristics and Outcomes of Patients With Vasospastic Angina

“…In the present study, the female VSA patients had lower prevalences of smoking, old myocardial infarction and organic coronary artery disease as compared with male patients, a consistent findings with the previous study. 22 Since women are generally protected from atherosclerosis by female hormones, 1,25,26 it is expected that female VSA patients had lower prevalence of organic coronary stenosis compared with male patients despite the higher age. The extent of atherosclerotic change of the coronary artery could influence the development of coronary spasm as there is a close topological relationship between coronary vasospasm and atherosclerosis in both animal models 27 and humans.…”

Intracoronary Administration of a Thromboxane A2 Synthase Inhibitor Relieves Acetyicholine-Induced Coronary Spasm.

“…As previously reported, [16][17][18][19][20][21][22] provocation of coronary vasospasms was performed with intracoronary injections of ACh at incremental doses of 20, 50 and 80 g into the right coronary artery and 20, 50 and 100 g into the left coronary artery over 20 s with at least a 3-min interval between each injection. Coronary arteriography was performed when STsegment changes, chest pain or both occurred and there was a 1-min interval until spasm relief.…”

Magnesium Deficiency in Patients With Recent Myocardial Infarction and Provoked Coronary Artery Spasm

“…After baseline coronary arteriograms were obtained, an intracoronary injection of acetylcholine or ergonovine was performed: [11][12][13][14][15] acetylcholine was injected in incremental doses of 20, 50, and 80 g into the right coronary artery and 20, 50, and 100 g into the left coronary artery over 20 s, and ergonovine was administered in total doses of 40 g into the right coronary artery and 64 g into the left coronary artery over 4 min. A USCI bipolar electrode catheter was inserted into the right ventricular apex through the femoral or antecubital vein and was connected to a temporary pacemaker, setting the rate at 45 beats/min during acetylcholine testing.…”