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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....

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Autores principales: Teragawa, Hiroki, Uchimura, Yuko, Oshita, Chikage, Hashimoto, Yu, Nomura, Shuichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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.
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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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