Nitroglycerin-Induced Headache is Associated With Mild Coronary Artery Disease in Patients With Chest Pain

Cho, Sook Hee; Jeong, Myung Ho; Park, In Hyae; Choi, Jong Soo; Yoon, Hyun Ju; Yoon, Nam Sik; Kim, Kye Hun; Moon, Jae Youn; Hong, Young Joon; Park, Hyung Wook; Kim, Ju Han; Ahn, Youngkeun; Cho, Jeong Gwan; Park, Jong Chun; Kang, Jung Chaee

doi:10.4070/kcj.2008.38.10.524

Cited by 2 publications

(2 citation statements)

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“…Hsi et al [ 11 ] demonstrated that nitrates caused more frequent headache episodes in patients with normal coronary arteries than in those with obstructive CAD, and our results are consistent with this explanation because in our study population, NIH developed more frequently in patients with normal coronary arteries than in those with obstructive CAD. Furthermore, in our study the finding that NIH developed more frequently in patients with single- than in those with multiple-vessel disease confirmed the findings of Cho et al [ 12 ], who had reported that NIH was associated with mild (nonobstructive) CAD in patients with chest pain.…”

Section: Discussionsupporting

confidence: 92%

“…A large number [ 9 , 10 ] of studies have shown that vasodilator response of the arterial smooth muscles to exogenous nitric oxide is significantly reduced in patients with atherosclerosis. In addition, nitrate-induced headache (NIH) episodes are more frequent in patients with normal coronary arteries than in patients with obstructive CAD [ 11 , 12 , 13 ]. However, there is no information about the relationship between NIH and coronary artery atherosclerotic burden and lesion complexity.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between Nitrate-Induced Headache and Coronary Artery Lesion Complexity

Erkan¹,

Kırış²,

Korkmaz³

et al. 2015

Med Princ Pract

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Objective: The aim of the present study was to investigate the association between nitrate-induced headache (NIH) and the complexity of coronary artery lesions in patients with stable coronary artery disease (CAD). Subjects and Methods: Two hundred and seventy-five patients with anginal chest pain who underwent coronary angiography were enrolled in the present study. NIH was defined as the presence of headache due to nitrate treatment (isosorbide mononitrate 40 mg) after excluding confounding factors. Coronary artery lesion complexity was assessed by the SYNTAX score (SXscore) using a dedicated computer software system. Results: The mean SXscore was lower in the patients with NIH than in patients without NIH (7.3 ± 5.2 vs. 14.4 ± 8.5, respectively; p < 0.001). Additionally, patients with NIH had a lower rate of multivessel disease compared with those without NIH (the mean number of diseased vessels was 1.5 ± 0.7 and 2.0 ± 07, respectively; p < 0.001). In multivariate analysis, increasing age (p = 0.02) and headache (p = 0.001) were found to be independent determinants of SXscore. Conclusion: The present study demonstrated an independent inverse association between NIH and SXscore. The NIH could provide important predictive information about coronary artery lesion complexity in patients with stable CAD.

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Section: Discussionsupporting

confidence: 92%