دورية أكاديمية

Prognosis in Women With Myocardial Ischemia in the Absence of Obstructive Coronary Disease ; Results From the National Institutes of Health–National Heart, Lung, and Blood Institute–Sponsored Women’s Ischemia Syndrome Evaluation (WISE)

التفاصيل البيبلوغرافية
العنوان: Prognosis in Women With Myocardial Ischemia in the Absence of Obstructive Coronary Disease ; Results From the National Institutes of Health–National Heart, Lung, and Blood Institute–Sponsored Women’s Ischemia Syndrome Evaluation (WISE)
المؤلفون: Johnson, B. Delia, Shaw, Leslee J., Buchthal, Steven D., Bairey Merz, C. Noel, Kim, Hee-Won, Scott, Katherine N., Doyle, Mark, Olson, Marian B., Pepine, Carl J., den Hollander, Jan, Sharaf, Barry, Rogers, William J., Mankad, Sunil, Forder, John R., Kelsey, Sheryl F., Pohost, Gerald M.
المصدر: Circulation ; volume 109, issue 24, page 2993-2999 ; ISSN 0009-7322 1524-4539
بيانات النشر: Ovid Technologies (Wolters Kluwer Health)
سنة النشر: 2004
الوصف: Background— We previously reported that 20% of women with chest pain but without obstructive coronary artery disease (CAD) had stress-induced reduction in myocardial phosphocreatine–adenosine triphosphate ratio by phosphorus-31 nuclear magnetic resonance spectroscopy (abnormal MRS), consistent with myocardial ischemia. The prognostic implications of these findings are unknown. Methods and Results— Women referred for coronary angiography for suspected myocardial ischemia underwent MRS handgrip stress testing and follow-up evaluation. These included (1) n=60 with no CAD/normal MRS, (2) n=14 with no CAD/abnormal MRS, and (3) n=352 a reference group with CAD. Cardiovascular events were death, myocardial infarction, heart failure, stroke, other vascular events, and hospitalization for unstable angina. Cumulative freedom from events at 3 years was 87%, 57%, and 52% for women with no CAD/normal MRS, no CAD/abnormal MRS, and CAD, respectively ( P <0.01). After adjusting for CAD and cardiac risk factors, a phosphocreatine–adenosine triphosphate ratio decrease of 1% increased the risk of a cardiovascular event by 4% ( P =0.02). The higher event rate in women with no CAD/abnormal MRS was primarily due to hospitalization for unstable angina, which is associated with repeat catheterization and higher healthcare costs. Conclusions— Among women without CAD, abnormal MRS consistent with myocardial ischemia predicted cardiovascular outcome, notably higher rates of anginal hospitalization, repeat catheterization, and greater treatment costs. Further evaluation into the underlying pathophysiology and possible treatment options for women with evidence of myocardial ischemia but without CAD is indicated.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1161/01.cir.0000130642.79868.b2
DOI: 10.1161/01.CIR.0000130642.79868.B2
الإتاحة: https://doi.org/10.1161/01.cir.0000130642.79868.b2Test
رقم الانضمام: edsbas.F3BD962A
قاعدة البيانات: BASE