title: Differences and interactions between risk factors for coronary spasm and atherosclerosis--smoking, aging, inflammation, and blood pressure.
abstract: Objective Coronary spasm as well as atherosclerosis plays an important role in the pathogenesis of coronary heart disease. However, the relationship between coronary spasm and atherosclerosis is not well known. The purpose of the present study was to examine the differences and interactions between risk factors for coronary spasm and atherosclerosis and thereby explore the pathogenesis of coronary spasm. Methods The study subjects consisted of 938 patients with chest discomfort (522 men and 416 women, mean age 65.2±11.0) who underwent intracoronary-acetylcholine provocation tests for coronary spasm. Coronary risk factors, including age, gender, body mass index, blood pressure, high-sensitivity C-reactive protein (hsCRP), white blood cells, glucose, lipid profiles, and other laboratory chemistries were examined. Results Four hundred and ninety-six patients (315 men and 181 women, mean age: 65.1±11.4) were diagnosed with coronary spastic angina (CSA), while the remaining 442 patients (207 men and 235 women, mean age: 65.3±10.7) were diagnosed with non-CSA. A multiple logistic regression analysis revealed men, smoking, hsCRP, and low diastolic blood pressure (DBP) to be predictors (p=0.001, p=0.009, p=0.034, and p=0.041, respectively) for CSA, while age, diabetes mellitus, low high-density lipoprotein-cholesterol, systolic blood pressure (SBP), uric acid and male gender were found to be predictors (p<0.001, p<0.001, p<0.001, p=0.002, p=0.006 and p=0.029, respectively) for atherosclerosis. Conclusion Predictors for coronary spasm were smoking, hsCRP and low DBP, whereas those for atherosclerosis were age, diabetes mellitus, high SBP, and uric acid in that order. These findings suggest that the pathogenesis of coronary spasm differs from that of atherosclerosis.
authors.affiliation: Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Japan.
authors.forename: Sumio
authors.initials: S
authors.lastname: Morita
authors.forename: Yuji
authors.initials: Y
authors.lastname: Mizuno
authors.forename: Eisaku
authors.initials: E
authors.lastname: Harada
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Morikawa
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Saito
authors.forename: Daisuke
authors.initials: D
authors.lastname: Katoh
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kashiwagi
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yasue
mesh_terms: D000368:Aged; D000375:Aging; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D050197:Atherosclerosis / Q000097:blood / Q000150:complications / Q000209:etiology / Q000503:physiopathology*; D001794:Blood Pressure; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002637:Chest Pain / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D003329:Coronary Vasospasm / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D007564:Japan; D008055:Lipids / Q000097:blood; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000503:physiopathology
chemical_list: D000889:Anti-Arrhythmia Agents; D002121:Calcium Channel Blockers; D008055:Lipids; D002097:C-Reactive Protein