Prevalence of Coronary Endothelial and Microvascular Dysfunction in Women with Symptoms of Ischemia and No Obstructive Coronary Artery Disease Is Confirmed by a New Cohort: The NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation–Coronary Vascular Dysfunction (WISE-CVD)
Objective. In a separate, contemporary cohort, we sought to confirm findings of the original Women’s Ischemia Syndrome Evaluation (WISE). Background. The original WISE observed a high prevalence of both invasively determined coronary endothelial and coronary microvascular dysfunction (CMD) that pred...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2019/7169275 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832562491711815680 |
|---|---|
| author | R. David Anderson John W. Petersen Puja K. Mehta Janet Wei B. Delia Johnson Eileen M. Handberg Saibal Kar Bruce Samuels Babak Azarbal Kamlesh Kothawade Sheryl F. Kelsey Barry Sharaf Leslee J. Shaw George Sopko C. Noel Bairey Merz Carl J. Pepine |
| author_facet | R. David Anderson John W. Petersen Puja K. Mehta Janet Wei B. Delia Johnson Eileen M. Handberg Saibal Kar Bruce Samuels Babak Azarbal Kamlesh Kothawade Sheryl F. Kelsey Barry Sharaf Leslee J. Shaw George Sopko C. Noel Bairey Merz Carl J. Pepine |
| author_sort | R. David Anderson |
| collection | DOAJ |
| description | Objective. In a separate, contemporary cohort, we sought to confirm findings of the original Women’s Ischemia Syndrome Evaluation (WISE). Background. The original WISE observed a high prevalence of both invasively determined coronary endothelial and coronary microvascular dysfunction (CMD) that predicted adverse events in follow-up. Methods. We comparatively studied the WISE-Coronary Vascular Dysfunction (CVD) cohort (2009-2011), with signs and symptoms of ischemia but without significant CAD, to the original WISE (1997-2001) cohort. CMD was defined as coronary flow reserve (CFR) ≤2.5, or endothelial dysfunction as epicardial coronary artery constriction to acetylcholine (ACH), or <20% epicardial coronary dilation to nitroglycerin (NTG). Results. In WISE (n=181) and WISE-CVD (n=235) women, mean age in both was 54 years, and 83% were white (WISE) vs 74% (WISE-CVD, p=0.04). Use of hormone replacement therapy was less frequent in WISE-CVD vs WISE (46% vs 57%, p=0.026) as was presence of hypertension (40% vs 52%, p=0.013), hyperlipidemia (20% vs 46%, p<0.0001), and smoking (46% vs 56%, p=0.036). Similar rates were observed in WISE-CVD and WISE cohorts for CMD (mean CFR 2.7±0.6 vs 2.6±0.8, p=0.35), mean change in diameter with intracoronary ACH (0.2±10.0 vs 1.6±12.8 mm, p=0.34), and mean change in diameter with intracoronary NTG (9.7±13.0 vs 9.8±13.5 mm, p=0.94), respectively. Conclusions. This study confirms prevalence of CMD in the contemporary WISE-CVD cohort similar to that of the original WISE cohort, despite a lower risk factor burden in WISE-CVD. Because these coronary functional abnormalities predict major adverse cardiac events, clinical trials of therapies targeting these abnormalities are indicated. |
| format | Article |
| id | doaj-art-a901422442bb42cebe41aa22a6ffe00b |
| institution | Kabale University |
| issn | 0896-4327 1540-8183 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-a901422442bb42cebe41aa22a6ffe00b2025-02-03T01:22:31ZengWileyJournal of Interventional Cardiology0896-43271540-81832019-01-01201910.1155/2019/71692757169275Prevalence of Coronary Endothelial and Microvascular Dysfunction in Women with Symptoms of Ischemia and No Obstructive Coronary Artery Disease Is Confirmed by a New Cohort: The NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation–Coronary Vascular Dysfunction (WISE-CVD)R. David Anderson0John W. Petersen1Puja K. Mehta2Janet Wei3B. Delia Johnson4Eileen M. Handberg5Saibal Kar6Bruce Samuels7Babak Azarbal8Kamlesh Kothawade9Sheryl F. Kelsey10Barry Sharaf11Leslee J. Shaw12George Sopko13C. Noel Bairey Merz14Carl J. Pepine15University of Florida, Gainesville, Florida, USAUniversity of Florida, Gainesville, Florida, USAEmory University School of Medicine, Atlanta, Georgia, USASmidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USAUniversity of Pittsburgh, Pittsburgh, Pennsylvania, USAUniversity of Florida, Gainesville, Florida, USASmidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USASmidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USASmidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USASmidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USAUniversity of Pittsburgh, Pittsburgh, Pennsylvania, USARhode Island Hospital, Providence, Rhode Island, USACardiovascular Outcomes Research and Epidemiology, Emory University, Atlanta, Georgia, USANational Institutes of Health/National Heart, Lung, and Blood Institute, Bethesda, Maryland, USASmidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USAUniversity of Florida, Gainesville, Florida, USAObjective. In a separate, contemporary cohort, we sought to confirm findings of the original Women’s Ischemia Syndrome Evaluation (WISE). Background. The original WISE observed a high prevalence of both invasively determined coronary endothelial and coronary microvascular dysfunction (CMD) that predicted adverse events in follow-up. Methods. We comparatively studied the WISE-Coronary Vascular Dysfunction (CVD) cohort (2009-2011), with signs and symptoms of ischemia but without significant CAD, to the original WISE (1997-2001) cohort. CMD was defined as coronary flow reserve (CFR) ≤2.5, or endothelial dysfunction as epicardial coronary artery constriction to acetylcholine (ACH), or <20% epicardial coronary dilation to nitroglycerin (NTG). Results. In WISE (n=181) and WISE-CVD (n=235) women, mean age in both was 54 years, and 83% were white (WISE) vs 74% (WISE-CVD, p=0.04). Use of hormone replacement therapy was less frequent in WISE-CVD vs WISE (46% vs 57%, p=0.026) as was presence of hypertension (40% vs 52%, p=0.013), hyperlipidemia (20% vs 46%, p<0.0001), and smoking (46% vs 56%, p=0.036). Similar rates were observed in WISE-CVD and WISE cohorts for CMD (mean CFR 2.7±0.6 vs 2.6±0.8, p=0.35), mean change in diameter with intracoronary ACH (0.2±10.0 vs 1.6±12.8 mm, p=0.34), and mean change in diameter with intracoronary NTG (9.7±13.0 vs 9.8±13.5 mm, p=0.94), respectively. Conclusions. This study confirms prevalence of CMD in the contemporary WISE-CVD cohort similar to that of the original WISE cohort, despite a lower risk factor burden in WISE-CVD. Because these coronary functional abnormalities predict major adverse cardiac events, clinical trials of therapies targeting these abnormalities are indicated.http://dx.doi.org/10.1155/2019/7169275 |
| spellingShingle | R. David Anderson John W. Petersen Puja K. Mehta Janet Wei B. Delia Johnson Eileen M. Handberg Saibal Kar Bruce Samuels Babak Azarbal Kamlesh Kothawade Sheryl F. Kelsey Barry Sharaf Leslee J. Shaw George Sopko C. Noel Bairey Merz Carl J. Pepine Prevalence of Coronary Endothelial and Microvascular Dysfunction in Women with Symptoms of Ischemia and No Obstructive Coronary Artery Disease Is Confirmed by a New Cohort: The NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation–Coronary Vascular Dysfunction (WISE-CVD) Journal of Interventional Cardiology |
| title | Prevalence of Coronary Endothelial and Microvascular Dysfunction in Women with Symptoms of Ischemia and No Obstructive Coronary Artery Disease Is Confirmed by a New Cohort: The NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation–Coronary Vascular Dysfunction (WISE-CVD) |
| title_full | Prevalence of Coronary Endothelial and Microvascular Dysfunction in Women with Symptoms of Ischemia and No Obstructive Coronary Artery Disease Is Confirmed by a New Cohort: The NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation–Coronary Vascular Dysfunction (WISE-CVD) |
| title_fullStr | Prevalence of Coronary Endothelial and Microvascular Dysfunction in Women with Symptoms of Ischemia and No Obstructive Coronary Artery Disease Is Confirmed by a New Cohort: The NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation–Coronary Vascular Dysfunction (WISE-CVD) |
| title_full_unstemmed | Prevalence of Coronary Endothelial and Microvascular Dysfunction in Women with Symptoms of Ischemia and No Obstructive Coronary Artery Disease Is Confirmed by a New Cohort: The NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation–Coronary Vascular Dysfunction (WISE-CVD) |
| title_short | Prevalence of Coronary Endothelial and Microvascular Dysfunction in Women with Symptoms of Ischemia and No Obstructive Coronary Artery Disease Is Confirmed by a New Cohort: The NHLBI-Sponsored Women’s Ischemia Syndrome Evaluation–Coronary Vascular Dysfunction (WISE-CVD) |
| title_sort | prevalence of coronary endothelial and microvascular dysfunction in women with symptoms of ischemia and no obstructive coronary artery disease is confirmed by a new cohort the nhlbi sponsored women s ischemia syndrome evaluation coronary vascular dysfunction wise cvd |
| url | http://dx.doi.org/10.1155/2019/7169275 |
| work_keys_str_mv | AT rdavidanderson prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT johnwpetersen prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT pujakmehta prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT janetwei prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT bdeliajohnson prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT eileenmhandberg prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT saibalkar prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT brucesamuels prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT babakazarbal prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT kamleshkothawade prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT sherylfkelsey prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT barrysharaf prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT lesleejshaw prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT georgesopko prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT cnoelbaireymerz prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd AT carljpepine prevalenceofcoronaryendothelialandmicrovasculardysfunctioninwomenwithsymptomsofischemiaandnoobstructivecoronaryarterydiseaseisconfirmedbyanewcohortthenhlbisponsoredwomensischemiasyndromeevaluationcoronaryvasculardysfunctionwisecvd |