Risk factors in coronary microcirculatory disease and acute coronary syndrome

    Authors

    Keywords

    coronary microcirculation, gender difference, obesity

    DOI

    https://doi.org/10.15836/ccar2016.456

    Full Text

    **Background:** According to previous studies, dysfunction of coronary microcirculation (CMD) is defined as reduced coronary flow reserve and/or endothelial dysfunction, presented with typical angina in absence of other myocardial/cardiovascular or systemic diseases, with electrocardiographic ischemic changes and normal/minimally changed coronarogram. The main pathophysiologic mechanism of CMD is endothelial dysfunction with impaired vasodilatation, coagulation, inflammation, permeability, cell adhesion, and altered microvascular response. (1, 2) Aim: To determine gender difference and risk factors in patients with slow flow coronary phenomena, without significant epicardial coronary artery stenosis, and typical angina-like chest pain. **Patients and Methods:** The study included 30 patients (14 males, 16 females) hospitalized because of chest pain, with ischemic electrocardiographic changes, normal coronarogram and coronary slow flow. To all patient standard biochemical blood analysis with cardiac enzymes were done, blood pressure and anthropometric measurements, transthoracic echocardiography and coronary angiography. **Results:** Arterial hypertension, diabetes mellitus, dyslipidemia, nicotinismus and family history did not showed significant gender difference, but significance was found in age range (p=0.032), male patients was younger than female. Also, early stage of weight increase, BMI over 25kg/m2, could present risk factor for coronary slow flow in both gender. **Conclusion:** In addition to standard risk factors that underlie coronary microcirculatory disease, obesity and ageing should be considered as a part of clinical presentation and aspect for further treatment.

    Literature

    1. Novo G, Novo S. Coronary microvascular dysfunction: an update. eJournal of the ESC Council for Cardiology Practice. 2014;13(5). Available at: (20.9.2016). http://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-13/Coronary-microvascular-dysfunction-an-update
    2. Selthofer-Relatić K, Bošnjak I, Kibel A. Obesity related coronary microvascular dysfunction: from basic to clinical practice. Cardiol Res Pract. 2016;2016:8173816. https://doi.org/10.1155/2016/8173816
    Cardiologia Croatica
    Back to search

    Risk factors in coronary microcirculatory disease and acute coronary syndrome

    Extended Abstract
    Issue10-11
    Published
    Pages456
    PDF via DOIhttps://doi.org/10.15836/ccar2016.456
    coronary microcirculation
    gender difference
    obesity

    Authors

    Tihana KurjakovićSchool of Medicine, University Josip Juraj Strossmayer Osijek, Osijek, Croatia
    Ivica BošnjakORCIDUniversity Hospital Centre Osijek, Osijek, Croatia
    Kristina Selthofer-Relatić*ORCIDUniversity Hospital Centre Osijek, Osijek, Croatia

    *Correspondence email: selthofer.relatic@gmail.com

    Full Text

    Background: According to previous studies, dysfunction of coronary microcirculation (CMD) is defined as reduced coronary flow reserve and/or endothelial dysfunction, presented with typical angina in absence of other myocardial/cardiovascular or systemic diseases, with electrocardiographic ischemic changes and normal/minimally changed coronarogram. The main pathophysiologic mechanism of CMD is endothelial dysfunction with impaired vasodilatation, coagulation, inflammation, permeability, cell adhesion, and altered microvascular response. (1, 2) Aim: To determine gender difference and risk factors in patients with slow flow coronary phenomena, without significant epicardial coronary artery stenosis, and typical angina-like chest pain.

    Patients and Methods: The study included 30 patients (14 males, 16 females) hospitalized because of chest pain, with ischemic electrocardiographic changes, normal coronarogram and coronary slow flow. To all patient standard biochemical blood analysis with cardiac enzymes were done, blood pressure and anthropometric measurements, transthoracic echocardiography and coronary angiography.

    Results: Arterial hypertension, diabetes mellitus, dyslipidemia, nicotinismus and family history did not showed significant gender difference, but significance was found in age range (p=0.032), male patients was younger than female. Also, early stage of weight increase, BMI over 25kg/m2, could present risk factor for coronary slow flow in both gender.

    Conclusion: In addition to standard risk factors that underlie coronary microcirculatory disease, obesity and ageing should be considered as a part of clinical presentation and aspect for further treatment.

    Literature

    1. 1.
      Novo G, Novo S. Coronary microvascular dysfunction: an update. eJournal of the ESC Council for Cardiology Practice. 2014;13(5). Available at: (20.9.2016).Link
    2. 2.
      Selthofer-Relatić K, Bošnjak I, Kibel A. Obesity related coronary microvascular dysfunction: from basic to clinical practice. Cardiol Res Pract. 2016;2016:8173816.DOI