Sex and Race Are Associated With the Absence of Epicardial Coronary Artery Obstructive Disease at Angiography in Patients With Acute Coronary Syndromes
Sex and Race Are Associated With the Absence of Epicardial Coronary Artery Obstructive Disease at Angiography in Patients With Acute Coronary Syndromes
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DOI：
10.1002/clc.20794
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发表时间：
2010-08-01
影响因子：
2.7
通讯作者：
Reynolds, Harmony R.
中科院分区：
文献类型：
--
作者：
Chokshi, Neel P.;Iqbal, Sohah N.;Reynolds, Harmony R.
背景资料：相当少的急性冠状动脉综合征（ACS）患者在血管造影时没有任何心外膜冠状动脉直径狭窄>= 50%（“血管造影时无阻塞”）。我们研究了这一发现的频率及其与种族和性别的关系。假设：在心肌梗死患者中，年龄较小、女性和非白人与血管造影时无阻塞性冠状动脉疾病相关。方法：我们回顾了2006年5月19日至2006年9月29日在私立（n = 793）和1家公立（n = 578）城市学术医疗中心进行的所有血管造影的结果。图表进行了审查的适应症和结果的血管造影术，和demographics.Results：队列包括518例ACS患者。106例患者（21%）血管造影时无阻塞，包括258例心肌梗死患者中的48例（18%）。在整个队列中（55/170名女性[32%] vs 51/348名男性[15%]，P < 0.001）和MI亚组中（29/90名女性[32%] vs 19/168名男性[11%]，P < 0.001），女性在血管造影时无梗阻的可能性高于男性。相对于任何其他亚组，黑人患者在血管造影时更可能无阻塞（24/66 [36%] vs 41/229 [18%]白人，31/150[21%]西班牙裔和5/58 [9%]亚洲人，P = 0.001）。在女性中，与其他族裔群体相比，黑人患者在血管造影时更容易出现无阻塞（16/27 [59%] vs 17/59 [29%]白人，17/60 [28%]西班牙裔和3/19 [6%]亚洲人，P = 0.001）。在多种族ACS患者样本中，冠状动脉造影发现大部分患者的冠状动脉直径没有>= 50%的狭窄。这在女性和黑人患者中尤为常见。
Background: A substantial minority of patients with acute coronary syndromes (ACS) do not have a diameter stenosis of any major epicardial coronary artery on angiography ("no obstruction at angiography") of >= 50%. We examined the frequency of this finding and its relationship to race and sex.Hypothesis: Among patients with myocardial infarction, younger age, female sex and non-white race are associated with the absence of obstructive coronary artery disease at angiography.Methods: We reviewed the results of all angiograms performed from May 19, 2006 to September 29, 2006 at private (n = 793) and 1 public (n = 578) urban academic medical center. Charts were reviewed for indication and results of angiography, and for demographics.Results: The cohort included 518 patients with ACS. There was no obstruction at angiography in 106 patients (21%), including 48 (18%) of 258 patients with myocardial infarction. Women were more likely to have no obstruction at angiography than men, both in the overall cohort (55/170 women [32%] vs 51/348 men [15%], P < 0.001) and in the subset with MI (29/90 women [32%] vs 19/168 men [11%], P < 0.001). Black patients were more likely to have no obstruction at angiography relative to any other subgroup (24/66 [36%] vs 41/229 [18%] Whites, 31/150[21%] Hispanics, and 5/58 [9%] Asians, P = 0.001). Among women, Black patients more frequently had no obstruction at angiography compared with other ethnic groups (16/27 [59%] vs 17/59 [29%] Whites, 17/60 [28%] Hispanics, and 3/19 [6%] Asians, P = 0.001).Conclusions: A high proportion of a multiethnic sample of patients with ACS were found to have no stenosis >= 50% in diameter at coronary angiography. This was particularly common among women and Black patients.