Vasospastic angina in women: Clinical backgrounds and prognoses of patients younger than and older than 60 years

Table 1 Patients’ characteristics

		Group O	Group Y	P value
No. (%)		77 (82)	17 (18)
Age (yr)		72 ± 7	54 ± 5	< 0.01
Body mass index		23.7 ± 4.5	24.5 ± 5.3	0.50
Coronary risk factors (%)
	Smoking (active/former/never)	3/5/69	3/4/10	< 0.01
	Hypertension	58 (75)	7 (41)	< 0.01
	Dyslipidemia	55 (77)	10 (59)	0.31
	Diabetes mellitus	12 (16)	2 (12)	0.68
Alcohol consumer (%)		10 (13)	5 (29)	0.09
Family history of CAD (%)		18 (23)	5 (29)	0.60
MtS (%)		13 (17)	4 (24)	0.52
CKD (%)		27 (35)	1 (6)	0.02

CAD: Coronary artery disease; CKD: Chronic kidney disease; MtS: Metabolic syndrome; No.: Number; Group O: Older than 60 years of age; Group Y: Younger than 60 years of age.

Table 2 Blood chemical parameters in the two groups

	Group O	Group Y	P value
Total cholesterol (mg/dL)	202 ± 33	196 ± 37	0.53
Triglyceride (mg/dL)	131 ± 73	119 ± 46	0.54
HDL-cholesterol (mg/dL)	63 ± 17	62 ± 18	0.82
LDL-cholesterol (md/dL)	113 ± 29	111 ± 32	0.82
Fasting blood sugar (md/dL)	100 ± 16	101 ± 17	0.93
Hemoglobin A1C (%)	6.0 ± 0.7	5.7 ± 0.6	0.10
C-reactive protein (mg/dL)	0.05 (0.02, 0.13)	0.07 (0.02, 0.15)	0.81
eGFR (mL/min/1.73 m2)	68.8 ± 16.8	77.5 ± 13.2	0.05
BNP (pg/mL)	22 (14, 54)	15 (10, 29)	0.09

BNP: Brain natriuretic peptide; eGFR: Estimated glomerular filtration ratio; HDL: High-density lipoprotein; LDL: Low-density lipoprotein; Group O: Older than 60 years of age; Group Y: Younger than 60 years of age.

Table 3 Echographic parameters in the two groups

			Group O	Group Y	P value
UCG
LVEF (%)			68 ± 9	66 ± 6	0.46
Brachial ultrasonography
All studied patients
	No.		77	17
	Heart rate (/min)		66 ± 10	67 ± 13	0.85
	Mean blood pressure		100 ± 14	94 ± 14	0.16
	Brachial blood flow
		Baseline (mL/min)	61 ± 44	59 ± 52	0.87
		% increase	384 ± 490	327 ± 265	0.59
	Brachial artery diameter (mm)
		Baseline	3.5 ± 0.5	3.5 ± 0.5	0.83
		Hyperemia	3.7 ± 0.5	3.6 ± 0.5	0.88
		After NTG	4.0 ± 0.5	4.2 ± 0.4	0.25
	FMD (%)		4.3 ± 3.2	4.5 ± 3.3	0.75
	NID (%)		13.6 ± 5.4	20.5 ± 8.6	< 0.01
Patients who did not take any coronary vasodilators
	No.		39	14
	Brachial artery diameter (mm)
		Baseline	3.5 ± 0.5	3.6 ± 0.4	0.68
		Hyperemia	3.6 ± 0.6	3.7 ± 0.4	0.60
		After NTG	4.0 ± 0.5	4.2 ± 0.4	0.21
	FMD (%)		4.1 ± 3.1	4.3 ± 3.5	0.82
	NID (%)		14.6 ± 5.7	18.5 ± 6.5	0.04

FMD: Flow-mediated dilation; LVEF: Left ventricular ejection fraction; NID: Nitroglycerin-induced dilation; NTG: Nitroglycerin; No.: Number; UCG: Echocardiography; Group O: Older than 60 years of age; Group Y: Younger than 60 years of age.

Table 4 Vasospastic angina-related parameters in the two groups

			Group O	Group Y	P value
Chest symptoms
Rest/Exercise/Both			60/9/9	14/1/2	0.78
Maximum duration of attack (min)			20 ± 27	16 ± 28	0.10
Diseased duration (M)			5 (1, 48)	12 (3, 42)	0.78
No. of anginal attacks (/M)
	At admission		4 (1, 10)	4 (1, 10)	0.43
	At follow-up		0 (0, 1)	2 (0.1, 2.8)	< 0.01
		No.	69	16
Medications
Taking statins at admission (%)			36 (47)	7 (46)	0.68
Taking antiplatelet drugs at admission (%)			20 (26)	1 (6)	0.07
Taking vasodilators at admission (%)			38 (49)	3 (18)	0.02
No. coronary vasodilators
	At admission		0 (0,1)	0 (0, 0)	0.01
			0.6 ± 0.7	0.2 ± 0.4	0.01
	At discharge		1 (1, 1)	1 (1, 1)	0.01
			1.2 ± 0.5	0.9 ± 0.3	0.02
	At follow-up		1 (1, 2)	1.5 (1, 2)	0.52
			1.5 ± 0.9	1.6 ± 0.9	0.53

M: Months; No.: Number; VSA: Vasospastic angina; Group O: Older than 60 years of age; Group Y: Younger than 60 years of age.

Table 5 Coronary angiography spasm provocation test parameters in the two groups

		Group O	Group Y	P value
CAG
Atherosclerotic change (%)		47 (61)	0 (0)	< 0.01
Myocardial bridging (%)		13 (17)	3 (18)	0.94
SPT
Focal/diffuse/focal and diffuse		16/48/33	0/15/2	0.08
Presence of focal spasm (%)		29 (38)	2 (12)	0.04
Multi-vessels spasm (%, No.)		39 (57, 68)	8 (67, 12)	0.56
Vessels of spasm
	RCA (%, No.)	44 (62, 71)	10 (67, 15)	0.72
	LAD (%, No.)	70 (96, 73)	13 (93, 14)	0.62
	LCX (%, No.)	5 (7, 72)	5 (38, 13)	< 0.01
An unavoidable use of NTG (%)		14 (18)	8 (47)	0.01
ST deviation during SPT (%)		10 (13)	5 (29)	0.09

CAG: Coronary angiography; LAD: Left anterior descending coronary artery; LCX: Left circumflex coronary artery; No.: Number; NTG: Nitroglycerin; RCA: Right coronary artery; SPT: Spasm provocation test; Group O: Older than 60 years of age; Group Y: Younger than 60 years of age.