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Relationship between Nitrate-Induced Headache and Coronary Artery Lesion Complexity
Hakan Erkan1, Gülhanım Kırış, Levent Korkmaz
1Department of Cardiology, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey.
Summary
Nitrate-induced headache (NIH) in stable coronary artery disease (CAD) patients is linked to less complex coronary artery lesions. This headache may predict simpler coronary artery disease, offering valuable clinical insights.
Area of Science:
- Cardiology
- Clinical Medicine
- Pharmacology
Background:
- Stable coronary artery disease (CAD) affects millions globally.
- Nitrate medications are common for angina but can cause side effects like headache.
- Understanding side effect associations may reveal underlying disease characteristics.
Purpose of the Study:
- To explore the relationship between nitrate-induced headache (NIH) and coronary artery lesion complexity in stable CAD patients.
- To determine if NIH is an independent predictor of lesion complexity.
Main Methods:
- 275 patients with stable CAD and chest pain undergoing coronary angiography were studied.
- Nitrate-induced headache (NIH) was identified after excluding other causes.
- Coronary artery lesion complexity was quantified using the SYNTAX score (SXscore).
Main Results:
- Patients experiencing NIH had significantly lower mean SXscores (7.3 vs. 14.4, p < 0.001).
- NIH patients also showed a lower incidence of multivessel disease (1.5 vs. 2.0 diseased vessels, p < 0.001).
- Increasing age and NIH were independent predictors of SXscore in multivariate analysis.
Conclusions:
- Nitrate-induced headache (NIH) is independently and inversely associated with coronary artery lesion complexity (SXscore).
- NIH may serve as a simple clinical indicator for less complex coronary artery lesions in stable CAD.
- This finding could aid in risk stratification and treatment planning for CAD patients.
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