Gender differences in factors associated with vasospastic angina

Saito, Yuki; Saito, Yuichi; Kato, Ken; Kobayashi, Yoshio

doi:10.1016/j.ijcard.2021.11.047

Cited by 8 publications

(3 citation statements)

References 31 publications

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“…Although there have been several reports on the characteristics of women with VSA[ 5 - 10 ], few reports have explored the characteristics of VSA by age[ 6 ]. Kawana et al [ 6 ] classified patients with VSA based on age: Under 50 years, 50–64 years, and over 65 years, and they found that although the prevalence of hypertension and dyslipidemia was lower in younger patients, the prevalence of smoking was higher.…”

Section: Discussionmentioning

confidence: 99%

“…Vasospastic angina (VSA) is a condition characterized by transient hypercontraction of the epicardial coronary arteries, leading to myocardial ischemia[ 1 , 2 ]. Although the incidence of coronary artery disease is higher in men[ 3 ], the incidence of VSA is relatively higher in women[ 4 , 5 ]. Therefore, several reports have investigated gender differences among patients with VSA[ 5 - 9 ], concluding that women have a lower positivity rate than men during the spasm provocation test (SPT)[ 5 - 9 ], and that focal spasms occur more frequently in men than in women[ 8 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Vasospastic angina in women: Clinical backgrounds and prognoses of patients younger than and older than 60 years

Teragawa¹,

Oshita²,

Uchimura³

2023

World J Cardiol

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BACKGROUND We frequently encounter cases of women with vasospastic angina (VSA). Additionally, some women with VSA are younger than 60 years old. However, it is unknown whether the characteristics of VSA in women aged < 60 years are different from those in women aged ≥ 60 years. AIM To investigate and compare the clinical characteristics and prognosis of VSA in women aged < 60 years from those in women aged ≥ 60 years. METHODS We enrolled 94 women with VSA who were diagnosed using the spasm provocation test. According to the age at diagnosis, the patients were divided into two groups: Group Y (age < 60 years, n = 17) and Group O (age ≥ 60 years, n = 77). Flow-mediated dilation (FMD) and nitroglycerin (NTG)-induced dilation (NID) of the brachial artery were performed and assessed using brachial ultrasonography. Moreover, conventional coronary risk factors, such as atherosclerotic lesions (stenosis > 20%) detected using coronary angiography and focal spasms (coronary spasm within one segment of one coronary artery), and major cardiovascular adverse events (MACE) were assessed in both groups. RESULTS Smoking was more prevalent in Group Y than in Group O ( P = 0.04). FMD was similar in both groups (Group O: 4.3% ± 3.2%, Group Y: 4.5% ± 3.3%; P = 0.75), whereas NID was higher in Group Y (20.5% ± 8.6%) than in Group O (13.6% ± 5.3%, P < 0.01). Atherosclerosis was not detected in Group Y but was detected in Group O (61%, P < 0.01). Focal spasms were less frequent in Group Y (12%) than in Group O (38%, P = 0.04). The incidence of major adverse cardiac events did not differ between the two groups (P = 0.40). CONCLUSION Women aged < 60 years with VSA have less atherosclerotic lesions and focal spasms. These characteristics may be affected by smoking habits and vascular smooth muscle dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vasospastic angina in women: Clinical backgrounds and prognoses of patients younger than and older than 60 years

Teragawa¹,

Oshita²,

Uchimura³

2023

World J Cardiol

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“…Invasive physio-logical assessment was preceded by ACh provocation tests in this study (Figure 1). Intracoronary ACh provocation tests were performed according to the recent Japanese guidelines [4,12], as previously reported [13]. In brief, vasodilation drugs, such as calcium channel blockers, long-acting nitrates, and nicorandil, were discontinued at least 48 h before the provocation tests.…”

Section: Acetylcholine Provocation Testmentioning

confidence: 99%

Thrombolysis in Myocardial Infarction Frame Count for Coronary Blood Flow Evaluation during Interventional Diagnostic Procedures

Yamazaki,

Saito,

Kitahara

et al. 2023

Medicina

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Background and Objectives: An interventional diagnostic procedure (IDP), including intracoronary acetylcholine (ACh) provocation and coronary physiological testing, is recommended as an invasive diagnostic standard for patients suspected of ischemia with no obstructive coronary arteries (INOCA). Recent guidelines suggest Thrombolysis In Myocardial Infarction frame count (TFC) as an alternative to wire-based coronary physiological indices for diagnosing coronary microvascular dysfunction. We evaluated trajectories of TFC during IDP and the impact of ACh provocation on TFC. Materials and Methods: This was a single-center, retrospective study. Patients who underwent IDP to diagnose INOCA were included and divided into two groups according to the positive or negative ACh provocation test. Wire-based invasive physiological assessment was preceded by ACh provocation tests and intracoronary isosorbide dinitrate (ISDN). We evaluated TFC at three different time points during IDP; pre-ACh, post-ISDN, and post-hyperemia. Results: Of 104 patients, 58 (55.8%) had positive ACh provocation test. In the positive ACh group, resting mean transit time (Tmn) and baseline resistance index were significantly higher than in the negative ACh group. Post-ISDN TFC was significantly correlated with resting Tmn (r = 0.31, p = 0.002). Absolute TFC values were highest at pre-ACh, followed by post-ISDN and post-hyperemia in both groups. All between-time point differences in TFC were statistically significant in both groups, except for the change from pre-ACh to post-ISDN in the positive ACh group. Conclusions: In patients suspected of INOCA, TFC was modestly correlated with Tmn, a surrogate of coronary blood flow. The positive ACh provocation test influenced coronary blood flow assessment during IDP.

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Relation of Vasoreactivity in the Left and Right Coronary Arteries During Acetylcholine Spasm Provocation Testing

Okuya,

Saito,

Kitahara

et al. 2024

The American Journal of Cardiology

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Gender differences in factors associated with vasospastic angina

Cited by 8 publications

References 31 publications

Vasospastic angina in women: Clinical backgrounds and prognoses of patients younger than and older than 60 years

Vasospastic angina in women: Clinical backgrounds and prognoses of patients younger than and older than 60 years

Thrombolysis in Myocardial Infarction Frame Count for Coronary Blood Flow Evaluation during Interventional Diagnostic Procedures

Relation of Vasoreactivity in the Left and Right Coronary Arteries During Acetylcholine Spasm Provocation Testing

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