title: Relationship between Nitrate-Induced Headache and Coronary Artery Lesion Complexity.
abstract: OBJECTIVE
  The aim of the present study was to investigate the association between nitrate-induced headache (NIH) and the complexity of coronary artery lesions in patients with stable coronary artery disease (CAD).
  
  
  METHODS
  Two hundred and seventy-five patients with anginal chest pain who underwent coronary angiography were enrolled in the present study. NIH was defined as the presence of headache due to nitrate treatment (isosorbide mononitrate 40 mg) after excluding confounding factors. Coronary artery lesion complexity was assessed by the SYNTAX score (SXscore) using a dedicated computer software system.
  
  
  RESULTS
  The mean SXscore was lower in the patients with NIH than in patients without NIH (7.3 ± 5.2 vs. 14.4 ± 8.5, respectively; p < 0.001). Additionally, patients with NIH had a lower rate of multivessel disease compared with those without NIH (the mean number of diseased vessels was 1.5 ± 0.7 and 2.0 ± 07, respectively; p < 0.001). In multivariate analysis, increasing age (p = 0.02) and headache (p = 0.001) were found to be independent determinants of SXscore.
  
  
  CONCLUSIONS
  The present study demonstrated an independent inverse association between NIH and SXscore. The NIH could provide important predictive information about coronary artery lesion complexity in patients with stable CAD.
authors.affiliation: Department of Cardiology, Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital, Trabzon, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Erkan
authors.forename: Gülhanım
authors.initials: G
authors.lastname: Kırış
authors.forename: Levent
authors.initials: L
authors.lastname: Korkmaz
authors.forename: Mustafa Tarık
authors.initials: MT
authors.lastname: Ağaç
authors.forename: İsmail Gökhan
authors.initials: İG
authors.lastname: Çavuşoğlu
authors.forename: İhsan
authors.initials: İ
authors.lastname: Dursun
authors.forename: Ahmet Seyda
authors.initials: AS
authors.lastname: Yılmaz
authors.forename: Ahmet Oğuz
authors.initials: AO
authors.lastname: Aslan
authors.forename: Dilek Cahide
authors.initials: DC
authors.lastname: Kırcı
authors.forename: Şükrü
authors.initials: Ş
authors.lastname: Çelik
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006261:Headache / Q000139:chemically induced*; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D014665:Vasodilator Agents; D007548:Isosorbide Dinitrate; C030397:isosorbide-5-mononitrate