Author + information
- Vedant Pargaonkar,
- Yuhei Kobayashi,
- Takumi Kimura,
- David Lee,
- Marcia Stefanick,
- William Fearon,
- Alan Yeung and
- Jennifer Tremmel
Background: While >20% of patients presenting to the cath lab with angina have no obstructive coronary artery disease (CAD), a majority (77%) have an occult coronary abnormality, including endothelial dysfunction and/or microvascular dysfunction (MVD), which may explain their symptoms. We studied sex differences in the risk factors for endothelial dysfunction and MVD in patients with angina in the absence of obstructive CAD.
Methods: We evaluated 193 patients (74.6% women) with angina and no obstructive CAD. Endothelial dysfunction was defined as a decrease in epicardial coronary diameter by >20% after intracoronary acetylcholine. MVD was defined as an index of microcirculatory resistance ≥ 25.
Results: The mean age was 53.8 ± 12 years. Endothelial dysfunction was present in 132 (68.4%) patients (102 women, 30 men) and MVD was present in 40 (20.7%) patients (33 women, 7 men). On multivariable logistic regression, higher serum triglyceride levels independently predicted the presence of endothelial dysfunction in women, while no risk factors were independent predictors in men. MVD was independently predicted by age in women, while diabetes mellitus predicted the presence of MVD in men (Table).
Conclusions: Sex differences exist in the risk factors for endothelial dysfunction and MVD in patients with angina in the absence of obstructive CAD. Targeted management of these modifiable risk factors according to sex may play an important role in primary prevention of these occult coronary abnormalities.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Current Issues in Cardiovascular Epidemiology, Disparities, and Safety
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1148-058
- 2017 American College of Cardiology Foundation