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Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group
AIMS: To provide multi-national, multi-ethnic data on the clinical characteristics and prognosis of patients with microvascular angina (MVA). METHODS AND RESULTS: The Coronary Vasomotor Disorders International Study Group proposed the diagnostic criteria for MVA. We prospectively evaluated the clini...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8633728/ https://www.ncbi.nlm.nih.gov/pubmed/34038937 http://dx.doi.org/10.1093/eurheartj/ehab282 |
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author | Shimokawa, Hiroaki Suda, Akira Takahashi, Jun Berry, Colin Camici, Paolo G Crea, Filippo Escaned, Javier Ford, Tom Yii, Eric Kaski, Juan Carlos Kiyooka, Takahiko Mehta, Puja K Ong, Peter Ozaki, Yukio Pepine, Carl Rimoldi, Ornella Safdar, Basmah Sechtem, Udo Tsujita, Kenichi Yasuda, Satoshi Beltrame, John F Merz, C Noel Bairey |
author_facet | Shimokawa, Hiroaki Suda, Akira Takahashi, Jun Berry, Colin Camici, Paolo G Crea, Filippo Escaned, Javier Ford, Tom Yii, Eric Kaski, Juan Carlos Kiyooka, Takahiko Mehta, Puja K Ong, Peter Ozaki, Yukio Pepine, Carl Rimoldi, Ornella Safdar, Basmah Sechtem, Udo Tsujita, Kenichi Yasuda, Satoshi Beltrame, John F Merz, C Noel Bairey |
author_sort | Shimokawa, Hiroaki |
collection | PubMed |
description | AIMS: To provide multi-national, multi-ethnic data on the clinical characteristics and prognosis of patients with microvascular angina (MVA). METHODS AND RESULTS: The Coronary Vasomotor Disorders International Study Group proposed the diagnostic criteria for MVA. We prospectively evaluated the clinical characteristics of patients according to these criteria and their prognosis. The primary endpoint was the composite of major cardiovascular events (MACE), verified by institutional investigators, which included cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization due to heart failure or unstable angina. During the period from 1 July 2015 to 31 December 2018, 686 patients with MVA were registered from 14 institutes in 7 countries from 4 continents. Among them, 64% were female and the main ethnic groups were Caucasians (61%) and Asians (29%). During follow-up of a median of 398 days (IQR 365–744), 78 MACE occurred (6.4% in men vs. 8.6% in women, P = 0.19). Multivariable Cox proportional hazard analysis disclosed that hypertension and previous history of coronary artery disease (CAD), including acute coronary syndrome and stable angina pectoris, were independent predictors of MACE. There was no sex or ethnic difference in prognosis, although women had lower Seattle Angina Questionnaire scores than men (P < 0.05). CONCLUSIONS: This first international study provides novel evidence that MVA is an important health problem regardless of sex or ethnicity that a diagnosis of MVA portends a substantial risk for MACE associated with hypertension and previous history of CAD, and that women have a lower quality of life than men despite the comparable prognosis. |
format | Online Article Text |
id | pubmed-8633728 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-86337282021-12-01 Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group Shimokawa, Hiroaki Suda, Akira Takahashi, Jun Berry, Colin Camici, Paolo G Crea, Filippo Escaned, Javier Ford, Tom Yii, Eric Kaski, Juan Carlos Kiyooka, Takahiko Mehta, Puja K Ong, Peter Ozaki, Yukio Pepine, Carl Rimoldi, Ornella Safdar, Basmah Sechtem, Udo Tsujita, Kenichi Yasuda, Satoshi Beltrame, John F Merz, C Noel Bairey Eur Heart J Clinical Research AIMS: To provide multi-national, multi-ethnic data on the clinical characteristics and prognosis of patients with microvascular angina (MVA). METHODS AND RESULTS: The Coronary Vasomotor Disorders International Study Group proposed the diagnostic criteria for MVA. We prospectively evaluated the clinical characteristics of patients according to these criteria and their prognosis. The primary endpoint was the composite of major cardiovascular events (MACE), verified by institutional investigators, which included cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization due to heart failure or unstable angina. During the period from 1 July 2015 to 31 December 2018, 686 patients with MVA were registered from 14 institutes in 7 countries from 4 continents. Among them, 64% were female and the main ethnic groups were Caucasians (61%) and Asians (29%). During follow-up of a median of 398 days (IQR 365–744), 78 MACE occurred (6.4% in men vs. 8.6% in women, P = 0.19). Multivariable Cox proportional hazard analysis disclosed that hypertension and previous history of coronary artery disease (CAD), including acute coronary syndrome and stable angina pectoris, were independent predictors of MACE. There was no sex or ethnic difference in prognosis, although women had lower Seattle Angina Questionnaire scores than men (P < 0.05). CONCLUSIONS: This first international study provides novel evidence that MVA is an important health problem regardless of sex or ethnicity that a diagnosis of MVA portends a substantial risk for MACE associated with hypertension and previous history of CAD, and that women have a lower quality of life than men despite the comparable prognosis. Oxford University Press 2021-05-26 /pmc/articles/PMC8633728/ /pubmed/34038937 http://dx.doi.org/10.1093/eurheartj/ehab282 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Clinical Research Shimokawa, Hiroaki Suda, Akira Takahashi, Jun Berry, Colin Camici, Paolo G Crea, Filippo Escaned, Javier Ford, Tom Yii, Eric Kaski, Juan Carlos Kiyooka, Takahiko Mehta, Puja K Ong, Peter Ozaki, Yukio Pepine, Carl Rimoldi, Ornella Safdar, Basmah Sechtem, Udo Tsujita, Kenichi Yasuda, Satoshi Beltrame, John F Merz, C Noel Bairey Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group |
title | Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group |
title_full | Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group |
title_fullStr | Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group |
title_full_unstemmed | Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group |
title_short | Clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the Coronary Vasomotor Disorders International Study (COVADIS) Group |
title_sort | clinical characteristics and prognosis of patients with microvascular angina: an international and prospective cohort study by the coronary vasomotor disorders international study (covadis) group |
topic | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8633728/ https://www.ncbi.nlm.nih.gov/pubmed/34038937 http://dx.doi.org/10.1093/eurheartj/ehab282 |
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