Detailed angiographic analysis of women with suspected ischemic chest pain (pilot phase data from the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation [WISE] study angiographic core laboratory)

Sharaf, Barry L.; Pepine, Carl J.; Kerensky, Richard A.; Reis, Steven E.; Reichek, Nathaniel; Rogers, William J.; Sopko, George; Kelsey, Sheryl F.; Holubkov, Richard; Olson, Marian B.; Miele, Nicholas J.; Williams, David O.; Merz, C. Noel Bairey

doi:10.1016/s0002-9149(01)01424-2

Cited by 240 publications

(187 citation statements)

References 27 publications

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“…Quantitative coronary angiography was performed. 4 Women with 1 or more Ն50% diameter stenosis were classified as having "significant" CAD, those with maximum stenosis of 20% to 50% had "minimal" CAD, and women with Ͻ20% stenoses in all coronary arteries had "no CAD." CAD severity score was calculated by a modified Gensini index.…”

Section: Methodsmentioning

confidence: 99%

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Mild Renal Insufficiency Is Associated With Angiographic Coronary Artery Disease in Women

et al. 2002

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Background-Mild renal insufficiency is associated with an increased risk for cardiovascular events in women with coronary artery disease (CAD). However, the relationship between mild renal insufficiency and atherosclerotic CAD in women is not known. Methods and Results-Women with chest pain who were referred for coronary angiography in the NHLBI Women's Ischemia Syndrome Evaluation (WISE) study underwent quantitative coronary angiography, blood measurements of creatinine, lipids, and homocysteine, and assessment of CAD risk factors. Fifty-six women had mild renal insufficiency (serum creatinine 1.2 to 1.9 mg/dL), and 728 had normal renal function (creatinine Ͻ1.2 mg/dL). Creatinine correlated with angiographic CAD severity score (rϭ0.11, PϽ0.004) and maximum coronary artery stenosis (rϭ0.11, PϽ0.003).Compared with women with normal renal function, those with mild renal insufficiency were more likely to have significant angiographic CAD (Ն50% diameter stenosis in Ն1 coronary artery) (61% versus 37%; PϽ0.001) and CAD in multiple vessels (PϽ0.001 for association) and had greater maximum percent diameter coronary stenosis (59Ϯ35% versus 38Ϯ36%; PϽ0.001). Mild renal insufficiency was associated with significant angiographic CAD independent of age and risk factors (ORϭ1.9, 95%CIϭ1.1 to 3.5). After controlling for homocysteine in 509 women, mild renal insufficiency remained predictive of CAD (ORϭ3.2, 95%CIϭ1.4 to 7.2). Conclusions-In women with chest pain, mild renal insufficiency is an independent predictor of significant angiographic CAD. Mildly increased serum creatinine is probably a marker for unmeasured proatherogenic factors.

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Section: Methodsmentioning

confidence: 99%

“…CAD severity score was calculated by a modified Gensini index. 4 Pittsburgh in the last consecutive 509 women. Samples and standards were treated with sodium borohydride (Sigma) and monobromobimane (Thiolyte Reagent, Calbiochem).…”

Section: Methodsmentioning

confidence: 99%

Mild Renal Insufficiency Is Associated With Angiographic Coronary Artery Disease in Women

et al. 2002

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“…Measurements included quantitative assessment as to the presence, severity, and complexity of epicardial coronary stenosis, using previously published methods. 24 Coronary artery disease (CAD) was defined as ≥50% stenosis in one or more epicardial arteries.…”

Section: Quantitative Coronary Angiographic Analysesmentioning

confidence: 99%

Lipid-Lowering Medication Use and Aggression Scores in Women: A Report from the NHLBI-Sponsored WISE Study

Olson

Kelsey

Matthews

et al. 2008

Journal of Women's Health

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Aim-The aim of this study was to examine the association between the use of lipid-lowering medication and aggressive responding, hostility, cynicism, and depression scores in women undergoing coronary angiography.Methods-The cohort included 498 women from the National Heart, Lung and Blood Institute (NHLBI)-sponsored Women's Ischemia Syndrome Evaluation (WISE) study. WISE is a four-center study of women with chest pain who underwent quantitative coronary angiography for suspected myocardial ischemia. The psychosocial indices included the Cook Medley Hostility questionnaire, measuring aggression, hostility, and cynicism, and the Beck Depression Inventory (BDI).Results-Compared to those not on lipid-lowering medication, women receiving lipid-lowering pharmacotherapy were older (62 vs. 55 years, p < 0.001) and had more hypertension, dyslipidemia, diabetes, and coronary artery disease (CAD, defined as ≥50% stenoses in at least one epicardial artery) (all p < 0.003). Women on lipid-lowering medication had higher aggressive responding scores than those not on medication, 3.0 ± 1.8 vs. 2.7 ± 1.7, respectively (age-adjusted p < 0.003). This association persisted after adjustment for coronary risk factors, education, and extent of angiographic disease (CAD) (p < 0.005), and after exclusion of women using psychotropic medications (p < 0.001). Hostility, cynicism, and depression scores did not differ by medication use.Conclusions-In women, lipid-lowering medication may predispose to aggression without affecting hostility or mood, but this hypothesis requires evaluation in placebo-controlled clinical trials.

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“…For quantitative coronary angiography, angiograms were analyzed by investigators blinded to patient data at the WISE angiographic core laboratory (Rhode Island Hospital, Providence, RI) as described previously. 13 Standard digital coronary angiographic images on CD-ROM were analyzed by a computer-based edge-detection method. Cine film images of lumen diameters were quantified by a projector-based cross-hair technique.…”

Section: Quantitative Coronary Angiographymentioning

confidence: 99%

Abnormal Coronary Vasomotion as a Prognostic Indicator of Cardiovascular Events in Women

et al. 2004

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Background-Coronary vascular dysfunction has been linked to atherosclerosis and adverse cardiovascular outcomes in men, but these relationships have not been firmly established in women. Methods and Results-As part of the Women's Ischemia Syndrome Evaluation (WISE) sponsored by the National Heart, Lung, and Blood Institute, 163 women referred for clinically indicated coronary angiography underwent coronary reactivity assessment with quantitative coronary angiography and intracoronary Doppler flow before and after intracoronary administration of acetylcholine, adenosine, and nitroglycerin and were then followed up for clinical outcomes. History of hypertension was present in 61%, dyslipidemia in 54%, diabetes in 26%, and current tobacco use in 21% of women enrolled. Seventy-five percent had no or only mild epicardial coronary artery disease (CAD). Over a median follow-up of 48 months, events occurred in 58 women. On bivariate analysis, women with an event had significantly less change in coronary cross-sectional area (⌬CSA) in response to acetylcholine (Pϭ0.0006) and nitroglycerin (Pϭ0.04). In addition, women with abnormal coronary dilator response to acetylcholine had less time free from cardiovascular events (Pϭ0.004). In multivariable analysis, after controlling for age, hypertension, diabetes, dyslipidemia, tobacco use, and CAD severity, %⌬CSA with acetylcholine (Pϭ0.001) independently predicted events. When the outcome was restricted to only death, myocardial infarction, congestive heart failure, and stroke, %⌬CSA with acetylcholine remained a significant predictor (Pϭ0.006). Conclusions-In

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Detailed angiographic analysis of women with suspected ischemic chest pain (pilot phase data from the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation [WISE] study angiographic core laboratory)

Cited by 240 publications

References 27 publications

Mild Renal Insufficiency Is Associated With Angiographic Coronary Artery Disease in Women

Mild Renal Insufficiency Is Associated With Angiographic Coronary Artery Disease in Women

Lipid-Lowering Medication Use and Aggression Scores in Women: A Report from the NHLBI-Sponsored WISE Study

Abnormal Coronary Vasomotion as a Prognostic Indicator of Cardiovascular Events in Women

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