非阻塞性冠心病患者冠状动脉内乙酰胆碱激发试验检测冠状动脉痉挛的性别差异

IF 1.6 3区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Ji Young Park, Se Yeon Choi, Seung-Woon Rha, Byoung Geol Choi, Yung-Kyun Noh, Yong Hoon Kim
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引用次数: 0

摘要

前言:心血管疾病在男性和女性中的表现不同。本研究的目的是比较非阻塞性心血管疾病(NOCVD)患者冠状动脉痉挛(CAS)特征的性别差异以及CAS患者按性别的临床结局。方法:本研究分析了2004年11月至2014年5月5491例接受乙酰胆碱激发试验评估胸痛的novd患者。在乙酰胆碱激发试验中,动脉管腔狭窄大于70%被定义为CAS。结果:患者分为男性2506例,女性2985例。平均随访时间1218±577天。为了校正混杂因素,对所有患者和CAS患者进行倾向评分匹配(PSM)分析。经PSM分析,所有患者共产生1201对,CAS患者共产生713对。在所有患者中,女性的CAS发生率明显低于男性(62.3% vs 50.9%, P < 0.01)。心肌桥(MB)和中度狭窄在女性中较少见,而刺激时短暂性ST段抬高和缺血性胸痛在女性中更为常见。在CAS患者中,男性多血管痉挛发生率高于女性(35.7%比29.7%,P < 0.01)。老年、血脂异常和MB是男性和女性发生CAS的独立危险因素。在CAS患者中,无论是男性还是女性,在长达5年的时间里,各种个体和综合主要结局没有统计学差异。在CAS患者中,年龄是5年主要心脏不良事件(MACE)的危险因素,中度狭窄是5年主要心脏不良事件(MACE)和5年复发心绞痛的危险因素。在CAS患者中,轻度狭窄是5年MACE的危险因素,而心肌桥是5年复发性心绞痛的危险因素。结论:在本研究中,在血管造影和临床参数、乙酰胆碱激发试验、CAS发生率、CAS危险因素、5年MACE、心绞痛复发等方面存在性别差异。老年、血脂异常和MB是男女发生CAS的独立危险因素。然而,CAS患者长达5年的主要临床结果没有性别差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Sex Difference in Coronary Artery Spasm Tested by Intracoronary Acetylcholine Provocation Test in Patients with Nonobstructive Coronary Artery Disease

Sex Difference in Coronary Artery Spasm Tested by Intracoronary Acetylcholine Provocation Test in Patients with Nonobstructive Coronary Artery Disease

Introduction. Cardiovascular diseases manifest differently in men and women. The purpose of this study is to compare the sex difference in the characteristics of coronary artery spasm (CAS) in patients with nonobstructive cardiovascular disease (NOCVD) and the clinical outcomes in accordance with sex in CAS patients. Methods. The study analysed 5,491 patients with NOCVD who underwent an acetylcholine provocation test from November 2004 to May 2014 for evaluation of chest pain. CAS was defined as greater than 70% of luminal narrowing of the artery during the acetylcholine provocation test. Results. The patients were divided into men (n = 2,506) and women (n = 2,985). Mean follow-up days were 1,218 ± 577 days. To adjust for confounding factors, the propensity score matching (PSM) analysis was performed in all patients and among the CAS patients. After PSM analysis, a total of 1,201 pairs in all patients and a total of 713 pairs in CAS patients were generated. In all patients, women showed significantly less incidence of CAS compared with men (62.3% vs 50.9%, P < 0.01). Myocardial bridge (MB) and moderate stenosis were less prevalent in women, while transient ST elevation and ischemic chest pain during provocation were more frequent in women. In CAS patients, men had a higher incidence of multivessel spasm than women (35.7% vs. 29.7%, P < 0.01). Old age, dyslipidemia, and MB were independent risk factors of CAS in both men and women. In CAS patients, there was no statistical differences for various individual and composite major outcomes up to five years in either men or women. In men with CAS, old age was a risk factor of a 5-year major adverse cardiac event (MACE), and moderate stenosis was a risk factor of both 5-year MACE and 5-year recurrent angina. In women with CAS, mild stenosis was a risk factor of 5-year MACE, while myocardial bridge was a risk factor of 5-year recurrent angina. Conclusions. In this study, there were sex differences in the angiographic and clinical parameters during the acetylcholine provocation test, incidence of CAS, risk factors of CAS, 5-year MACE, and recurrent angina. Old age, dyslipidemia, and MB were independent risk factors of CAS in both sexes. However, major clinical outcomes up to five years in CAS patients were not different according to sex.

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来源期刊
Journal of interventional cardiology
Journal of interventional cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.80
自引率
0.00%
发文量
81
审稿时长
6-12 weeks
期刊介绍: Journal of Interventional Cardiology is a peer-reviewed, Open Access journal that provides a forum for cardiologists determined to stay current in the diagnosis, investigation, and management of patients with cardiovascular disease and its associated complications. The journal publishes original research articles, review articles, and clinical studies focusing on new procedures and techniques in all major subject areas in the field, including: Acute coronary syndrome Coronary disease Congenital heart diseases Myocardial infarction Peripheral arterial disease Valvular heart disease Cardiac hemodynamics and physiology Haemostasis and thrombosis
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