TY - JOUR
T1 - Coronary microvascular dysfunction is not associated with a history of reproductive risk factors in women with angina pectoris
T2 - An iPOWER substudy
AU - Suhrs, Hannah Elena
AU - Kristensen, Anna Meta
AU - Rask, Anna Bay
AU - Michelsen, Marie Mide
AU - Frestad, Daria
AU - Mygind, Naja Dam
AU - Bové, Kira
AU - Prescott, Eva
N1 - Copyright © 2017 Elsevier B.V. All rights reserved.
PY - 2018/1
Y1 - 2018/1
N2 - Background Reproductive risk factors such as preeclampsia and recurrent miscarriages have been associated with adverse cardiovascular (CV) events. Underlying coronary microvascular dysfunction (CMD) may be a common denominator. Purpose We investigated whether a history of reproductive risk factors was associated with CMD in women with angina pectoris and no obstructive coronary artery disease (CAD). Methods Participants from the iPOWER study, including women with angina pectoris and no obstructive CAD (<50% stenosis), were invited to complete an electronic survey regarding reproductive risk factors: recurrent miscarriages, gestational diabetes, preeclampsia, rhesus immunity, polycystic ovary syndrome and menopausal status as well as migraine and Raynaud phenomenon. CMD was assessed by transthoracic Doppler echocardiography with measurement of coronary flow velocity reserve (CFVR) during high-dose dipyridamole infusion, and analyzed in three categories with cut-off points at 2.0 and 2.5. Associations between CFVR and a history of reproductive risk factors were examined by age-adjusted trend test. Results The questionnaire was completed by 613 women (73% of those invited), of whom 550 had a successful CFVR measurement. There was no significant difference in baseline characteristics between participants and non-participants. Median (interquartile range (IQR)) age was 62.8 (54.8; 68.7) years, median (IQR) BMI 26.2 (23.2; 29.8) kg/m2, and 81.5% were postmenopausal. We did not find any significant associations between any of the reproductive risk factors, Raynaud's phenomenon or migraine and CFVR. Conclusion The lack of association between coronary microvascular function and a history of reproductive risk factors, migraine and Raynaud's phenomenon suggests that a common vascular pathophysiological mechanism underlying these conditions is unlikely.
AB - Background Reproductive risk factors such as preeclampsia and recurrent miscarriages have been associated with adverse cardiovascular (CV) events. Underlying coronary microvascular dysfunction (CMD) may be a common denominator. Purpose We investigated whether a history of reproductive risk factors was associated with CMD in women with angina pectoris and no obstructive coronary artery disease (CAD). Methods Participants from the iPOWER study, including women with angina pectoris and no obstructive CAD (<50% stenosis), were invited to complete an electronic survey regarding reproductive risk factors: recurrent miscarriages, gestational diabetes, preeclampsia, rhesus immunity, polycystic ovary syndrome and menopausal status as well as migraine and Raynaud phenomenon. CMD was assessed by transthoracic Doppler echocardiography with measurement of coronary flow velocity reserve (CFVR) during high-dose dipyridamole infusion, and analyzed in three categories with cut-off points at 2.0 and 2.5. Associations between CFVR and a history of reproductive risk factors were examined by age-adjusted trend test. Results The questionnaire was completed by 613 women (73% of those invited), of whom 550 had a successful CFVR measurement. There was no significant difference in baseline characteristics between participants and non-participants. Median (interquartile range (IQR)) age was 62.8 (54.8; 68.7) years, median (IQR) BMI 26.2 (23.2; 29.8) kg/m2, and 81.5% were postmenopausal. We did not find any significant associations between any of the reproductive risk factors, Raynaud's phenomenon or migraine and CFVR. Conclusion The lack of association between coronary microvascular function and a history of reproductive risk factors, migraine and Raynaud's phenomenon suggests that a common vascular pathophysiological mechanism underlying these conditions is unlikely.
KW - Abortion, Habitual/epidemiology
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Angina Pectoris/epidemiology
KW - Coronary Circulation
KW - Coronary Vessels/physiology
KW - Diabetes, Gestational/epidemiology
KW - Echocardiography, Doppler
KW - Female
KW - Humans
KW - Microcirculation
KW - Middle Aged
KW - Migraine Disorders/epidemiology
KW - Polycystic Ovary Syndrome/epidemiology
KW - Pre-Eclampsia/epidemiology
KW - Pregnancy
KW - Raynaud Disease/epidemiology
KW - Risk Factors
KW - Young Adult
U2 - 10.1016/j.maturitas.2017.07.004
DO - 10.1016/j.maturitas.2017.07.004
M3 - Journal article
C2 - 28807722
SN - 0378-5122
VL - 107
SP - 110
EP - 115
JO - Maturitas
JF - Maturitas
ER -
