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Frequency and Clinical Impact of Family History of Coronary Artery Disease in Patients with Vasospastic Angina
Background: Family history (FH) of coronary artery disease (CAD) [FH-CAD] is a well-known risk factor for atherosclerotic CAD. However, FH-CAD frequency in patients with vasospastic angina (VSA) remains unknown, and the clinical characteristics and prognosis of VSA patients with FH-CAD are unclear....
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299202/ https://www.ncbi.nlm.nih.gov/pubmed/37367414 http://dx.doi.org/10.3390/jcdd10060249 |
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author | Teragawa, Hiroki Uchimura, Yuko Oshita, Chikage Hashimoto, Yu Nomura, Shuichi |
author_facet | Teragawa, Hiroki Uchimura, Yuko Oshita, Chikage Hashimoto, Yu Nomura, Shuichi |
author_sort | Teragawa, Hiroki |
collection | PubMed |
description | Background: Family history (FH) of coronary artery disease (CAD) [FH-CAD] is a well-known risk factor for atherosclerotic CAD. However, FH-CAD frequency in patients with vasospastic angina (VSA) remains unknown, and the clinical characteristics and prognosis of VSA patients with FH-CAD are unclear. Therefore, this study compared FH-CAD frequency between patients with atherosclerotic CAD and those with VSA and examined the clinical characteristics and prognosis of VSA patients with FH-CAD. Methods: Coronary angiography and spasm provocation tests (SPT) were used to investigate chest pain of coronary artery origin in patients classified into atherosclerotic CAD (362 cases), VSA (221 cases; positive for SPT) and non-VSA (73 cases; negative for SPT) groups, with FH-CAD being defined. In the VSA group, flow-mediated vasodilation (FMD) and nitroglycerin-independent vasodilation (NID) via brachial artery echocardiography and clinical symptoms in the groups with and without FH-CAD were checked, with Kaplan–Meier curves revealing major adverse cardiovascular events (cardiac death and rehospitalisation for cardiovascular disease) between the two groups. Results: The atherosclerotic CAD group had a significantly lower FH-CAD frequency (12%, p = 0.029) than the VSA (19%) and non-VSA groups (19%). FH-CAD was more common in females in the VSA and non-VSA groups than in the atherosclerotic CAD group (p < 0.001). Nonpharmacological treatment for CAD in FH-CAD was more common in the atherosclerotic CAD group (p = 0.017). In the VSA group, FH-CAD tended to be more common in females (p = 0.052). Although no differences in FMD of the brachial artery were observed between the groups, the FH-CAD (+) group had significantly higher NID than the FH-CAD (−) group (p = 0.023). Kaplan–Meier’s analysis revealed a similar prognosis between the two groups, and other clinical characteristics did not differ. Conclusion: Patients with VSA have a higher FH-CAD frequency than those with atherosclerotic CAD, especially in females. Although FH-CAD may affect vascular function in patients with VSA, its effect on the severity and prognosis of VSA appears to be minimal. FH-CAD and its confirmation may assist in CAD diagnosis, especially in female patients. |
format | Online Article Text |
id | pubmed-10299202 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-102992022023-06-28 Frequency and Clinical Impact of Family History of Coronary Artery Disease in Patients with Vasospastic Angina Teragawa, Hiroki Uchimura, Yuko Oshita, Chikage Hashimoto, Yu Nomura, Shuichi J Cardiovasc Dev Dis Article Background: Family history (FH) of coronary artery disease (CAD) [FH-CAD] is a well-known risk factor for atherosclerotic CAD. However, FH-CAD frequency in patients with vasospastic angina (VSA) remains unknown, and the clinical characteristics and prognosis of VSA patients with FH-CAD are unclear. Therefore, this study compared FH-CAD frequency between patients with atherosclerotic CAD and those with VSA and examined the clinical characteristics and prognosis of VSA patients with FH-CAD. Methods: Coronary angiography and spasm provocation tests (SPT) were used to investigate chest pain of coronary artery origin in patients classified into atherosclerotic CAD (362 cases), VSA (221 cases; positive for SPT) and non-VSA (73 cases; negative for SPT) groups, with FH-CAD being defined. In the VSA group, flow-mediated vasodilation (FMD) and nitroglycerin-independent vasodilation (NID) via brachial artery echocardiography and clinical symptoms in the groups with and without FH-CAD were checked, with Kaplan–Meier curves revealing major adverse cardiovascular events (cardiac death and rehospitalisation for cardiovascular disease) between the two groups. Results: The atherosclerotic CAD group had a significantly lower FH-CAD frequency (12%, p = 0.029) than the VSA (19%) and non-VSA groups (19%). FH-CAD was more common in females in the VSA and non-VSA groups than in the atherosclerotic CAD group (p < 0.001). Nonpharmacological treatment for CAD in FH-CAD was more common in the atherosclerotic CAD group (p = 0.017). In the VSA group, FH-CAD tended to be more common in females (p = 0.052). Although no differences in FMD of the brachial artery were observed between the groups, the FH-CAD (+) group had significantly higher NID than the FH-CAD (−) group (p = 0.023). Kaplan–Meier’s analysis revealed a similar prognosis between the two groups, and other clinical characteristics did not differ. Conclusion: Patients with VSA have a higher FH-CAD frequency than those with atherosclerotic CAD, especially in females. Although FH-CAD may affect vascular function in patients with VSA, its effect on the severity and prognosis of VSA appears to be minimal. FH-CAD and its confirmation may assist in CAD diagnosis, especially in female patients. MDPI 2023-06-08 /pmc/articles/PMC10299202/ /pubmed/37367414 http://dx.doi.org/10.3390/jcdd10060249 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Teragawa, Hiroki Uchimura, Yuko Oshita, Chikage Hashimoto, Yu Nomura, Shuichi Frequency and Clinical Impact of Family History of Coronary Artery Disease in Patients with Vasospastic Angina |
title | Frequency and Clinical Impact of Family History of Coronary Artery Disease in Patients with Vasospastic Angina |
title_full | Frequency and Clinical Impact of Family History of Coronary Artery Disease in Patients with Vasospastic Angina |
title_fullStr | Frequency and Clinical Impact of Family History of Coronary Artery Disease in Patients with Vasospastic Angina |
title_full_unstemmed | Frequency and Clinical Impact of Family History of Coronary Artery Disease in Patients with Vasospastic Angina |
title_short | Frequency and Clinical Impact of Family History of Coronary Artery Disease in Patients with Vasospastic Angina |
title_sort | frequency and clinical impact of family history of coronary artery disease in patients with vasospastic angina |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299202/ https://www.ncbi.nlm.nih.gov/pubmed/37367414 http://dx.doi.org/10.3390/jcdd10060249 |
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