title: Alcohol flushing and positive ethanol patch test in patients with coronary spastic angina: possible role of aldehyde dehydrogenase 2 polymorphisms.
abstract: OBJECTIVE
  Coronary spasm plays an important role in the pathogenesis of coronary heart disease (CHD) and angina pectoris caused by coronary spasm or coronary spastic angina (CSA) is prevalent in Japan. However, the precise mechanisms underlying coronary spasm are unclear. Alcohol intolerance is prevalent among East Asians, and we previously reported that coronary spasm could be induced by alcohol intake in CSA patients. We herein examined whether CSA is associated with alcohol intolerance in Japanese subjects.
  
  
  METHODS
  The study subjects consisted of 80 CSA patients (57 men/ 23 women, mean age 62 ± 12) and 52 non-CSA patients (25 men/27 women, mean age 63 ± 10). The ethanol patch test (EPT) and questionnaire which evaluates flushing after ethanol intake, along with an examination of clinical features and laboratory chemistry data for CHD risk factors were done. Gender (male) and smoking were higher (p=0.007, and p=0.019, respectively) and plasma HDL cholesterol level was lower (p=0.035) in the CSA patients than in the non-CSA patients. Multivariable logistic regression analysis including age, EPT, smoking, and plasma HDL cholesterol level as independent variables revealed that positive EPT and smoking were significant predictors of CSA (p=0.011 and p=0.016, respectively).
  
  
  CONCLUSIONS
  Positive EPT and alcohol flushing following alcohol intake, as well as smoking and plasma levels of HDL cholesterol, were significantly associated with CSA in Japanese patients. Therefore, alcohol ingestion as well as smoking is a significant risk factor for CSA in Japanese.
authors.affiliation: Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Mizuno
authors.forename: Sumio
authors.initials: S
authors.lastname: Morita
authors.forename: Eisaku
authors.initials: E
authors.lastname: Harada
authors.forename: Makoto
authors.initials: M
authors.lastname: Shono
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Morikawa
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yasue
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects*; D000444:Aldehyde Dehydrogenase / Q000235:genetics*; D000071396:Aldehyde Dehydrogenase, Mitochondrial; D000787:Angina Pectoris / Q000201:enzymology / Q000209:etiology* / Q000235:genetics; D044466:Asian People / Q000235:genetics; D016022:Case-Control Studies; D003329:Coronary Vasospasm / Q000201:enzymology / Q000209:etiology* / Q000235:genetics; D000431:Ethanol / Q000009:adverse effects; D005260:Female; D005483:Flushing / Q000201:enzymology / Q000209:etiology* / Q000235:genetics; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010328:Patch Tests; D011110:Polymorphism, Genetic; D012307:Risk Factors
chemical_list: D000431:Ethanol; C096127:ALDH2 protein, human; D000444:Aldehyde Dehydrogenase; D000071396:Aldehyde Dehydrogenase, Mitochondrial