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Hyperthyroidism Is Associated with the Development of Vasospastic Angina, but Not with Cardiovascular Outcomes.

ABSTRACT: Vasospastic angina (VA) is a functional disease caused by the alteration of vasomotor tone. We investigated the association of hyperthyroidism with the development and prognosis of VA. Study data were obtained from a prospective multicenter registry that included patients who had symptoms suggestive of VA. Coronary angiography and an ergonovine provocation test were performed, and patients were classified into a VA and a non-VA group. Among 1239 patients with suspected VA, 831 patients were classified in the VA group. Hyperthyroidism was more common in the VA group than in the non-VA group (10.0% vs. 3.7%, p < 0.001). After adjusting for confounding factors, hyperthyroidism was independently associated with a 3.27-fold increased risk of VA. Especially in women, hyperthyroidism was associated with a 4.38-fold higher risk of VA. All-cause death rates did not differ according to the presence or absence of hyperthyroidism. Hyperthyroidism is independently associated with the occurrence of VA especially in women but did not affect the total death in VA patients. Clinicians need to be aware of the role of thyroid function in patients with suspected VA.

SUBMITTER: Kim HJ

PROVIDER: S-EPMC7565955 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Hyperthyroidism Is Associated with the Development of Vasospastic Angina, but Not with Cardiovascular Outcomes.

Kim Hyun-Jin HJ Jo Sang-Ho SH Lee Min-Ho MH Seo Won-Woo WW Baek Sang Hong SH

Journal of clinical medicine 20200919 9

Vasospastic angina (VA) is a functional disease caused by the alteration of vasomotor tone. We investigated the association of hyperthyroidism with the development and prognosis of VA. Study data were obtained from a prospective multicenter registry that included patients who had symptoms suggestive of VA. Coronary angiography and an ergonovine provocation test were performed, and patients were classified into a VA and a non-VA group. Among 1239 patients with suspected VA, 831 patients were clas ...[more]

PMID: 32961722

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Project description:AimsCoronary microvascular dysfunction and/or vasospasm are potential causes of ischaemia in patients with no obstructive coronary artery disease (INOCA). We tested the hypothesis that these patients also have functional abnormalities in peripheral small arteries.Methods and resultsPatients were prospectively enrolled and categorised as having microvascular angina (MVA), vasospastic angina (VSA) or normal control based on invasive coronary artery function tests incorporating probes of endothelial and endothelial-independent function (acetylcholine and adenosine). Gluteal biopsies of subcutaneous fat were performed in 81 subjects (62 years, 69% female, 59 MVA, 11 VSA, and 11 controls). Resistance arteries were dissected enabling study using wire myography. Maximum relaxation to ACh (endothelial function) was reduced in MVA vs. controls [median 77.6 vs. 98.7%; 95% confidence interval (CI) of difference 2.3-38%; P = 0.0047]. Endothelium-independent relaxation [sodium nitroprusside (SNP)] was similar between all groups. The maximum contractile response to endothelin-1 (ET-1) was greater in MVA (median 121%) vs. controls (100%; 95% CI of median difference 4.7-45%, P = 0.015). Response to the thromboxane agonist, U46619, was also greater in MVA (143%) vs. controls (109%; 95% CI of difference 13-57%, P = 0.003). Patients with VSA had similar abnormal patterns of peripheral vascular reactivity including reduced maximum relaxation to ACh (median 79.0% vs. 98.7%; P = 0.03) and increased response to constrictor agonists including ET-1 (median 125% vs. 100%; P = 0.02). In all groups, resistance arteries were ≈50-fold more sensitive to the constrictor effects of ET-1 compared with U46619.ConclusionsSystemic microvascular abnormalities are common in patients with MVA and VSA. These mechanisms may involve ET-1 and were characterized by endothelial dysfunction and enhanced vasoconstriction.Clinical trial registrationClinicalTrials.gov registration is NCT03193294.

Dataset Information

Hyperthyroidism Is Associated with the Development of Vasospastic Angina, but Not with Cardiovascular Outcomes.

Publications

Hyperthyroidism Is Associated with the Development of Vasospastic Angina, but Not with Cardiovascular Outcomes.

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