27 November 2018

In European Journal of Preventive Cardiology Regina Konst and colleagues demonstrated that symptomatic women without obstructive coronary artery disease have a different pattern of risk factors and lower levels of psychosocial well-being compared with those with stable obstructive coronary artery disease.

characterising patients with symptoms/signs of ischemic heart disease in the absence of obstructed coronary arteries (INOCA) remains challenging. Little is known about differences in risk factors and psychosocial well-being of these patients compared to those with stable angina due to obstructive coronary artery disease (CAD). Therefore, we evaluated patient characteristics in women with INOCA and women with CAD.
64 symptomatic women aged 40-65 years with INOCA and 64 age-matched symptomatic women with CAD completed questionnaires about traditional cardiovascular risk factors, non-traditional risk variables and psychosocial factors such as fatigue, cardiac anxiety, quality of life and anxiety/depression.
Results: no significant differences were found regarding most traditional cardiovascular risk factors. Of the non-traditional risk variables, women with INOCA more often had a history of rheumatic disorders (39% vs. 21%; p < 0,01) and premenopausal migraine (52% vs. 31%; p = 0,02) compared to women with CAD. Women with INOCA reported higher levels of fatigue (89,7 ± 25,3 vs. 76,4 ± 26,9, p < 0,01) and cardiac anxiety (1,5 ± 0,5 vs. 1,3 ± 0,5, p < 0,05) and lower levels of physical quality of life (34,3 ± 10,3 vs. 41,4 ± 10,2, p < 0,01) compared to women with CAD, all related to a higher symptom burden. Levels of anxiety and depression were overall low in both groups without significant differences.
women with INOCA have a different pattern of risk factors and experience more psychosocial distress – related to a higher symptom burden – compared to women with stable obstructive CAD.

Different cardiovascular risk factors and psychosocial burden in symptomatic women with and without obstructive coronary artery disease.
Konst RE, Elias-Smale SE, Lier A, Bode C, Maas AH.

Regina Konst is member of theme Vascular damage. 

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