B-type natriuretic peptide after hormone therapy in postmenopausal women with chest pain and normal coronary angiogram

2008 ◽  
Vol 15 (2) ◽  
pp. 352-356 ◽  
Author(s):  
Hiroaki Kawano ◽  
Yasuhiro Nagayoshi ◽  
Hirofumi Soejima ◽  
Yasuaki Tanaka ◽  
Jun Hokamaki ◽  
...  
Keyword(s):  
Chest Pain ◽  
Hormone Therapy ◽  
Postmenopausal Women ◽  
Natriuretic Peptide ◽  
Coronary Angiogram ◽  
Normal Coronary Angiogram

Abstract 2450: A Randomized Controlled Trial of Low Dose Hormone Therapy on Myocardial Ischemia in Postmenopausal Women with No Obstructive Coronary Artery Disease:Results from the NHLBI-sponsored WISE

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
C. Bairey Merz ◽  
Marian Olson ◽  
Candace McClure ◽  
James Symons ◽  
George Sopko ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chest Pain ◽  
Coronary Artery ◽  
Endothelial Dysfunction ◽  
Myocardial Ischemia ◽  
Hormone Therapy ◽  
Postmenopausal Women ◽  
Brachial Artery ◽  
Low Dose

Background: Compared with men, women have more evidence of myocardial ischemia in the setting of no obstructive coronary artery disease (CAD). While low endogenous estrogen levels are associated with endothelial dysfunction, the role of low dose hormone therapy has not been fully evaluated in women suffering from myocardial ischemia and no obstructive CAD. Objective: This WISE ancillary trial evaluated the effect of low dose hormone therapy in postmenopausal women with myocardial ischemia and no obstructive CAD on: endothelial dysfunction, assessed by brachial artery reactivity, physical functional disability assessed by exercise testing, and quality of life assessed by cardiac symptoms and psychological questionnaires. Methods: Using a multicenter, randomized, placebo-controlled design, seventy-four participants with normal/minimally diseased epicardial coronary arteries (<50% luminal diameter stenosis) who fulfilled the inclusion criteria were planned to be randomized to receive either 1 mg norethindrone/10 mcg ethinyl estradiol (1/10 NA/EE) or placebo for twelve weeks. Baseline and exit brachial artery reactivity (BART), exercise stress testing, WISE psychosocial questionnaires, SF-36, blood lipids and hormone levels were evaluated. Results: Recruitment was closed prematurely due to failure to recruit in the year following publication of the Women’s Health Initiative hormone trial results. Of the 37 women randomized, 35 completed the study. While there was no difference in the frequency of chest pain between groups at the baseline visit, at study exit there was less frequent chest pain in the 1/10 NA/EE group compared to the placebo group (p=0.02). Women taking 1/10 NA/EE also showed a trend to improved BART and exercise tolerance, and had significantly fewer hot flashes/night sweats (p=0.003), less avoidance of intimacy (p=0.05), and borderline differences in sexual desire and vaginal dryness (p=0.06). Conclusion: Among postmenopausal women with myocardial ischemia and no obstructive CAD, hormone therapy with 1/10 NA/EE is associated with reduced chest pain symptoms, menopausal symptoms and improved quality of life with trends for improved endothelial function and exercise performance.

Pattern of exercise-induced ST change is related to coronary flow reserve in patients with chest pain and normal coronary angiogram

2005 ◽  
Vol 101 (2) ◽  
pp. 299-304 ◽  
Author(s):  
Ho-Joong Youn ◽  
Chul-Soo Park ◽  
Eun-Joo Cho ◽  
Hae-Ok Jung ◽  
Hui-Kyung Jeon ◽  
...  
Keyword(s):  
Chest Pain ◽  
Coronary Flow Reserve ◽  
Coronary Flow ◽  
Coronary Angiogram ◽  
Flow Reserve ◽  
Normal Coronary Angiogram ◽  
Exercise Induced

Abstract 3500: Cardiovascular Risk in Women with Non-Specific Chest Pain: Women’s Health Initiative Hormone Trials

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Jennifer G Robinson ◽  
Robert Wallace ◽  
Marian Limacher ◽  
Hong Ren ◽  
Barbara Cochrane ◽  
...  
Keyword(s):  
Chest Pain ◽  
Hormone Therapy ◽  
Postmenopausal Women ◽  
Treatment Strategies ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
Estrogen Plus Progestin ◽  
Primary Hospital ◽  
Intent To Treat

Context: Women discharged with a diagnosis of nonspecific chest pain (NSCP) may have an increased risk of subsequent coronary heart disease (CHD) events. The influence of hormone therapy on NSCP is unknown. Methods: The WHI enrolled postmenopausal women aged 50 –79 years. After excluding women with prior cardiovascular disease, 9427 women in the estrogen alone (E-Alone) trial and 15,105 women in the estrogen plus progestin (E + P) trial were included in this analysis. NSCP, defined as having a primary hospital discharge diagnosis of NSCP by ICD-9 code, was reported in 322 E-Alone and 249 E + P women. Risks of subsequent CHD events were estimated using intent-to-treat Cox proportional hazard ratio (HR) models stratified by clinic and adjusted for age and other risk factors. Results: In the fully adjusted models of the combined trials, women with NSCP had a 2-fold greater risk of subsequent nonfatal CHD events including nonfatal myocardial infarction [2.3% vs 1.7%, HR 2.10 (1.11–3.98)], revascularization [3.5% vs 2.6%, HR 1.99 (1.20 –3.30)], and hospitalized angina [3.7% vs 2.3%, HR 2.39 (1.46 –3.92)]. Hormone therapy did not have a significant effect on either the incidence of NSCP hospitalizations [HRs (95% CIs): E-Alone 1.04 (0.81–1.32); E + P 0.78 (0.59 –1.02)] or on the risk of a subsequent CHD event over 7.1 or 5.6 years of follow-up, respectively. Conclusion: A NSCP hospitalization doubles the risk of a subsequent CHD event in postmenopausal women over the next 5 to 7 years. Further research is needed to identify appropriate diagnosis and treatment strategies for women with NSCP.

scholarly journals The Incidence of Gastro-Esophageal Disease for the Patients with Typical Chest Pain and a Normal Coronary Angiogram

2006 ◽  
Vol 21 (2) ◽  
pp. 94 ◽  
Author(s):  
Chang-Wook Nam ◽  
Kee-Sik Kim ◽  
Young-Soo Lee ◽  
Sang-Hoon Lee ◽  
Seong-Wook Han ◽  
...  
Keyword(s):  
Chest Pain ◽  
Esophageal Disease ◽  
Coronary Angiogram ◽  
Normal Coronary Angiogram ◽  
Typical Chest Pain
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