Gender differences in factors associated with vasospastic angina. (15th February 2022)

• Record Type: Journal Article
• Authors: Saito, Yuki; Saito, Yuichi; Kato, Ken; Kobayashi, Yoshio
• Is Part Of: International journal of cardiology. Volume 349(2022)
• Page Start: 7
• Page End: 11
• Publication Date: 2022-02-15
• Subjects: Vasospastic angina -- Gender difference -- High-density lipoprotein cholesterol -- Smoking; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2021.11.047
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Vasospastic angina (VSA) is reportedly associated with several clinical characteristics such as smoking and high-density lipoprotein (HDL) cholesterol, in which gender differences are present. For instance, smoking rates among men are higher than those among women, and a normal range of HDL cholesterol differs across genders. However, their impact between men and women on VSA is unclear. Methods: A total of 797 patients (427 men and 370 women) undergoing intracoronary acetylcholine (ACh) provocation test to diagnose VSA were included. The positive ACh provocation test was defined as angiographic vasospasm accompanied by chest pain and/or ischemic electrocardiographic changes. Factors contributing to VSA across genders were evaluated by multivariable analyses. Results: Of 797 patients, 414 (51.9%) had positive ACh provocation test. The incidence of positive ACh test was higher in men than in women (56.9% vs. 46.2%, p = 0.003). In the entire study population, current smoking and a lower HDL cholesterol level were determined as factors associated with VSA. In both men and women, an HDL cholesterol level was identified as a factor contributing to positive ACh test. Conclusions: Among patients suspected for VSA, men as compared with women were more likely to have positive ACh provocation test. While current smoking and an HDL cholesterol level were associated with VSA in the entire study population, a lower HDL cholesterol level was determined as the only factor contributing to positive ACh test across genders, suggesting that HDL cholesterol plays important roles in the mechanism of VSA. Highlights: Clinical factors associated with vasospastic angina (VSA) across genders are unclear. Smoking and HDL cholesterol were factors associated with VSA in the entire population. A lower HDL cholesterol level was the only factor for predicting VSA across genders. HDL cholesterol may play an important role in the mechanism of VSA.