Gender-specific prognosis and risk impact of C-reactive protein, hemoglobin and platelet in the development of coronary spasm.
BACKGROUND
Scarce data are available on hemoglobin and platelet in relation to coronary artery spasm (CAS) development. We sought to determine the roles that high-sensitivity C-reactive protein (hs-CRP), hemoglobin and platelet play in CAS patients.


METHODS
Patients (337 women and 532 men) undergoing coronary angiography with or without CAS but without obstructive coronary artery disease were evaluated during a 12-year period.


RESULTS
Among women with high hemoglobin levels, the odds ratios (OR) from the lowest (<1 mg/l) to the highest tertiles (>3 mg/l) of hs-CRP were 1.21, 2.15, and 5.93 (p=0.009). In women with low hemoglobin levels, an elevated risk was found from the middle to the highest tertiles of hs-CRP (OR 0.59 to 3.85) (p=0.004). This relationship was not observed in men. In men, platelet count was the most significant risk factor for CAS (p=0.004). The highest likelihood of developing CAS was found among women with the highest hs-CRP tertile and low platelet counts (OR 8.77; 95% confidence interval [CI] 2.20-35.01) and among men with the highest hs-CRP tertile and high platelet counts (OR 4.58; 95% CI 0.48-43.97). Neither hemoglobin level nor platelet count was associated with frequent recurrent angina in both genders with CAS whereas death and myocardial infarction were rare.


CONCLUSIONS
There are positive interactions among hs-CRP, hemoglobin and platelet in women with this disease, but not in men. While hemoglobin is a modifier in CAS development in women, platelet count is an independent risk factor for men. Both women and men have good prognosis of CAS.
Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Ming-Yow
MY
Hung
Kuang-Hung
KH
Hsu
Wei-Syun
WS
Hu
Nen-Chung
NC
Chang
Chun-Yao
CY
Huang
Ming-Jui
MJ
Hung
D000368:Aged; D001792:Blood Platelets / Q000378:metabolism*; D002097:C-Reactive Protein / Q000378:metabolism*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000378:metabolism* / Q000503:physiopathology; D003329:Coronary Vasospasm / Q000378:metabolism* / Q000503:physiopathology; D005260:Female; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012727:Sex Characteristics; D016896:Treatment Outcome
D006454:Hemoglobins; D002097:C-Reactive Protein
C-reactive protein; coronary spasm; gender; hemoglobin; platelets