TCT-437 The Impact of Gender difference on Angiographic Characteristics During intracoronary acetylcholine provocation test in Korean patients
- 1 Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea, Republic of
- 2 Cardiovascular Department, Eulji General Hospital, Eulji University, Seoul, Korea, Republic of
Background
The gender difference is known to be a predictor of coronary artery spasm (CAS). However, angiographic characteristics during ACh provocation test according to the gender difference was rarely reported.
Methods
A total 2504 consecutive patients without significant coronary artery disease who underwent the acetylcholine(ACh) provocation test were enrolled between November 2004 and October 2010. The patients were divided into two groups according to gender (male : n=1158, female : n=1346).
Results
At baseline, the incidence of current smoking and the level of body mass index, triglyceride, and uric acid were higher in male patients. But, the level of low density lipoprotein and high density lipoprotein were higher in female patients. At angiographic characteristics, the incidence of myocardial bridge, ACh induced CAS, multivessel and diffuse spasm, chest pain during the ACh provocation test were higher in male patients. Multivariate analysis showed that male gender was a predictor of ACh induced CAS (odds ratio : 1.245, 95% confidence interval: 1.004-1.543, p<0.001), and old age, current smoking, myocardial bridge and baseline spasm were also a predictor of ACh induced CAS.
Conclusions
In this study, male patients was more associated with conventional cardiovascular risk factors and also a independent predictor of ACh induced CAS, and multiple and diffuse spasm. Therefore, gender difference must be considered in antianginal treatment and male patients with CAS would require more intensive treatment and close clinical follow up.
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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