The Feminine Face of Ischemic Heart Disease: Challenges and Opportunities
In: Journal of the American College of Cardiology, Jg. 73 (2018-11-28), Heft 6
Online
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Zugriff:
BACKGROUND: Currently as many as half of women with suspected myocardial ischemia have no obstructive CAD, and abnormal coronary reactivity (CR) is commonly found. OBJECTIVES: We prospectively investigated CR and longer-term adverse cardiovascular outcomes in women with and with no obstructive CAD in the National Heart, Lung and Blood Institute-sponsored Women’s Ischemia Syndrome Evaluation (WISE). METHODS: Women (n=224) with signs and symptoms of ischemia underwent CR testing. Coronary flow reserve (CFR) and coronary blood flow (CBF) were obtained to test microvascular function, while epicardial CR was tested by coronary dilation response to intracoronary (IC) acetylcholine and IC-nitroglycerine. All-cause mortality, major adverse cardiovascular events (MACE) [cardiovascular death, myocardial infarction, stroke, and heart failure] and angina hospitalizations served as clinical outcomes over a median follow-up of 9.7 years. RESULTS: We identified 129 events during the follow-up period. Low CFR was predictor of increased MACE rate (HR 1.06; 95% CI 1.01–1.12, p=0.021), while low CBF was associated with increased risk of mortality (HR=1.12; 95% CI 1.01–1.24, p=0.038) and MACE (HR= 1.11; 95% CI 1.03–1.20, p=0.006) after adjusting for cardiovascular risk factors. In addition, a decrease in cross-sectional area in response to IC-acetylcholine was associated with higher hazard of angina hospitalization (HR=1.05; 95% CI 1.02–1.07, p
Titel: |
The Feminine Face of Ischemic Heart Disease: Challenges and Opportunities
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Autor/in / Beteiligte Person: | Nanette K, Wenger |
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Zeitschrift: | Journal of the American College of Cardiology, Jg. 73 (2018-11-28), Heft 6 |
Veröffentlichung: | 2018 |
Medientyp: | unknown |
ISSN: | 1558-3597 (print) |
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