Sex differences in obstructive coronary artery disease in patients 65 years of age or older with angina pectoris.

Background and Objective: The pathophysiology of isolated coronary artery ectasia (CAE) remains poorly understood although associations between CAE and a broad spectrum of different diseases, especially atherosclerotic coronary artery disease have been reported. This study aimed to investigate the clinical characteristics of CAE and its relationship to obstructive artery disease in the Chinese Population. Methods and Results: This study recruited 3793 consecutive patients who had undergone coronary angiography for suspected coronary artery disease (CAD) between January 2009 and December 2014. The median age of the patients was 63 years (range, 27 to 94 years) and the majority (69.71%) was male. There were 3068 patients with obstructive coronary artery disease, including angina pectoris (n=1611), acute myocardial infarction (n=1265), and old myocardial infarction (n=192). A total of 120 cases (Male, n=93, female, n=27) with a median age of 63 years (range, 28-86) were identified as CAE in patients undergoing coronary angiography. Co-existent CAD was present in 94% of CAE patients, including 56 angina pectoris; 53 acute myocardial infarction; and 4 old myocardial infarction cases. The prevalence of CAE in patients with obstructive coronary artery disease was 3.67%. The frequency of arterial involvement was: right coronary artery (RCA), 63%; left anterior descending artery (LAD), 43%; left circumflex artery (LCX), 38%; and left main artery (LM), 14%. CAE affected only 1 major vessel in 83% of cases, 2 vessels in 12%, and all 3 vessels in 5%. Using multivariate analysis, serum levels of uric acid were independently associated with present of CAE (P<0.001), while other cardiovascular risk factors such age, arterial hypertension, dyslipidemia, smoking, and diabetes mellitus did not show statistically significant associations (P>0.05). Conclusion: The prevalence of CAE in patients with obstructive coronary artery disease was 3.67%. The RCA was the most commonly affected and most patients had single vessel involvement. Increased serum uric acid level may be a potential risk factor for presence of CAE.

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Coronary microvascular function and myocardial fibrosis in women with angina pectoris and no obstructive coronary artery disease: the iPOWER study

Journal of Cardiovascular Magnetic Resonance ◽

10.1186/s12968-016-0295-5 ◽

2016 ◽

Vol 18 (1) ◽

Cited By ~ 20

Author(s):

Naja Dam Mygind ◽

◽

Marie Mide Michelsen ◽

Adam Pena ◽

Abbas Ali Qayyum ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Angina Pectoris ◽

Myocardial Fibrosis ◽

Obstructive Coronary Artery Disease ◽

Microvascular Function ◽

Artery Disease ◽

Coronary Microvascular Function

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Biomarkers of Myocardial Fibrosis are Associated with Diabetes but not with Coronary Microvascular Dysfunction in Women with Angina and No Obstructive Coronary Artery Disease

10.21203/rs.3.rs-36838/v1 ◽

2020 ◽

Author(s):

Kira Bang Bove ◽

Naja Dam Mygind ◽

Signe Holm Nielsen ◽

Marie Mide Michelsen ◽

Daria Frestad Bechsgaard ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Angina Pectoris ◽

Myocardial Fibrosis ◽

Obstructive Coronary Artery Disease ◽

Microvascular Dysfunction ◽

Coronary Microvascular Dysfunction ◽

Transthoracic Doppler Echocardiography ◽

Type Iv ◽

Artery Disease

Abstract Background Coronary microvascular dysfunction (CMD) is highly prevalent in women with no obstructive coronary artery disease and possibly related to myocardial fibrosis caused by excessive extracellular matrix (ECM) remodeling. ECM turnover can be measured in blood indicating fibrotic activity. We hypothesized that women with DM, angina and no obstructive coronary artery disease have increased ECM turnover and that this is associated with CMD.Methods We included 344 women with angina pectoris and no obstructive coronary artery disease (187 with DM, predominantly type II) and 76 asymptomatic women without DM as controls. Biomarkers reflecting formation of type IV and VI collagen (PRO-C4 and PRO-C6) and degradation of type IV, V and VI collagen (C4M, C5M, C6M), mimecan (MIM) and titin (TIM) were measured in all participants. CMD was defined as coronary flow velocity reserve (CFVR) <2.0 assessed by transthoracic Doppler echocardiography.Results Median age was 64.2 (IQR 57.0-70.0), slightly higher in symptomatic women with DM. Median CFVR was 2.21 (1.89-2.55) in symptomatic women with DM, 2.35 (1.96-2.77) in symptomatic women without DM and 2.63 (2.19-2.95) in controls (age-adjusted p for trend<0.001). With exception of CM5, women with DM had significantly higher levels of all ECM biomarkers than women without DM (age-adjusted p<0.01), whereas biomarkers did not differ between symptomatic women without DM and controls. High ECM biomarker levels were associated with HbA1c, high BMI, low HDL and high triglycerides (p=0.003-0.0001). There was no correlation between ECM biomarkers and CFVR.Conclusion Women with angina pectoris and DM had increased levels of myocardial fibrosis biomarkers compared with women without DM. There was no association between CMD and biomarkers of myocardial fibrosis.

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