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Gender differences in factors associated with vasospastic angina
Yuki Saito1, Yuichi Saito2, Ken Kato2
1Chiba University School of Medicine, Chiba, Japan.
International Journal of Cardiology
|November 22, 2021
Summary
Men are more likely to have vasospastic angina (VSA) than women. Lower high-density lipoprotein (HDL) cholesterol is a key factor contributing to VSA in both genders, highlighting its role in the condition.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Vasospastic angina (VSA) is linked to smoking and high-density lipoprotein (HDL) cholesterol.
- Known gender differences exist in smoking rates and normal HDL cholesterol levels.
- The specific impact of these factors on VSA between genders remains unclear.
Purpose of the Study:
- To investigate gender-specific factors contributing to vasospastic angina (VSA).
- To evaluate the role of smoking and HDL cholesterol in VSA across genders.
Main Methods:
- Included 797 patients (427 men, 370 women) undergoing intracoronary acetylcholine (ACh) provocation tests for VSA diagnosis.
- Defined positive ACh test as angiographic vasospasm with chest pain or ischemic ECG changes.
- Utilized multivariable analyses to assess contributing factors to VSA across genders.
Main Results:
- 414 patients (51.9%) had a positive ACh test; incidence was higher in men (56.9%) than women (46.2%).
- Current smoking and lower HDL cholesterol levels were associated with VSA in the entire cohort.
- Lower HDL cholesterol was identified as a contributing factor to positive ACh tests in both men and women.
Conclusions:
- Men showed a higher likelihood of positive ACh provocation tests for VSA compared to women.
- While smoking and HDL cholesterol were associated with VSA overall, lower HDL cholesterol was the sole cross-gender factor.
- Findings suggest a significant role for HDL cholesterol in the underlying mechanisms of VSA.
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