Interactions among gender, age, hypertension and C-reactive protein in coronary vasospasm

Ming-Yow Hung, Kuang Hung Hsu, Ming Jui Hung, Chi Wen Cheng, Wen Jin Cherng

Research output: Contribution to journalArticle

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Abstract

Background Coronary vasospasm (CVsp) has been reported to be an inflammatory disease, reflected by elevated high-sensitivity C-reactive protein (hs-CRP). We investigated the interactions among gender, age, hypertension and hs-CRP in patients with CVsp.Materials and methods We retrospectively examined 722 Taiwanese patients with or without CVsp during an 8-year period. None of the patients had obstructive coronary artery disease. Serum hs-CRP levels were examined in a subset of 375 patients to evaluate the interactions of hs-CRP with gender, age, smoking and hypertension in the development of CVsp.Results In women, only the highest hs-CRP tertile (> 3 mg L-1) was independently associated with CVsp. In men, age > 58 years and the highest hs-CRP tertile were independently associated with CVsp. In women, elevated risk was only demonstrated in patients ≤ 58 years of age with hs-CRP levels in the highest tertile. In men, a positively monotonic trend was demonstrated between hs-CRP levels and CVsp in those > 58 years of age. The odds ratios of CVsp in both women and men with hs-CRP in the highest tertile reduced from 6.01 to 1.48 and 6.35-2.69 respectively, if they had hypertension.Conclusion The relationship between hs-CRP and CVsp differed between men and women. Our findings that there is a non-threshold model in men and a threshold model in women provide evidence that more smokers in men (life-style) and age (induction time) contribute to the natural history of CVsp development. The negative effect of hypertension on CVsp suggests that the pathogenesis of CVsp differs from that of coronary atherosclerosis.

Original languageEnglish
Pages (from-to)1094-1103
Number of pages10
JournalEuropean Journal of Clinical Investigation
Volume40
Issue number12
DOIs
Publication statusPublished - Dec 2010

Fingerprint

Coronary Vasospasm
C-Reactive Protein
Hypertension
Coronary Artery Disease

Keywords

  • Age
  • Coronary vasospasm
  • Gender
  • High-sensitivity C-reactive protein
  • Hypertension

ASJC Scopus subject areas

  • Medicine(all)
  • Clinical Biochemistry
  • Biochemistry

Cite this

Interactions among gender, age, hypertension and C-reactive protein in coronary vasospasm. / Hung, Ming-Yow; Hsu, Kuang Hung; Hung, Ming Jui; Cheng, Chi Wen; Cherng, Wen Jin.

In: European Journal of Clinical Investigation, Vol. 40, No. 12, 12.2010, p. 1094-1103.

Research output: Contribution to journalArticle

Hung, Ming-Yow ; Hsu, Kuang Hung ; Hung, Ming Jui ; Cheng, Chi Wen ; Cherng, Wen Jin. / Interactions among gender, age, hypertension and C-reactive protein in coronary vasospasm. In: European Journal of Clinical Investigation. 2010 ; Vol. 40, No. 12. pp. 1094-1103.
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N2 - Background Coronary vasospasm (CVsp) has been reported to be an inflammatory disease, reflected by elevated high-sensitivity C-reactive protein (hs-CRP). We investigated the interactions among gender, age, hypertension and hs-CRP in patients with CVsp.Materials and methods We retrospectively examined 722 Taiwanese patients with or without CVsp during an 8-year period. None of the patients had obstructive coronary artery disease. Serum hs-CRP levels were examined in a subset of 375 patients to evaluate the interactions of hs-CRP with gender, age, smoking and hypertension in the development of CVsp.Results In women, only the highest hs-CRP tertile (> 3 mg L-1) was independently associated with CVsp. In men, age > 58 years and the highest hs-CRP tertile were independently associated with CVsp. In women, elevated risk was only demonstrated in patients ≤ 58 years of age with hs-CRP levels in the highest tertile. In men, a positively monotonic trend was demonstrated between hs-CRP levels and CVsp in those > 58 years of age. The odds ratios of CVsp in both women and men with hs-CRP in the highest tertile reduced from 6.01 to 1.48 and 6.35-2.69 respectively, if they had hypertension.Conclusion The relationship between hs-CRP and CVsp differed between men and women. Our findings that there is a non-threshold model in men and a threshold model in women provide evidence that more smokers in men (life-style) and age (induction time) contribute to the natural history of CVsp development. The negative effect of hypertension on CVsp suggests that the pathogenesis of CVsp differs from that of coronary atherosclerosis.

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