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https://hdl.handle.net/2440/9847
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Type: | Journal article |
Title: | Major racial differences in coronary constrictor response between Japanese and Caucasians with recent myocardial infarction |
Author: | Pristipino, C. Beltrame, J. Finocchiaro, M. Hattori, R. Fujita, M. Mongiardo, R. Cianflone, D. Sanna, T. Sasayama, S. Maseri, A. |
Citation: | Circulation, 2000; 101(10):1102-1108 |
Publisher: | Lippincott Williams & Wilkins |
Issue Date: | 2000 |
ISSN: | 0009-7322 1524-4539 |
Statement of Responsibility: | Christian Pristipino, John F. Beltrame, Maria L. Finocchiaro, Ryuichi Hattori, Masatoshi Fujita, Rocco Mongiardo, Domenico Cianflone, Tommaso Sanna, Shigetake Sasayama, Attilio Maseri |
Abstract: | <h4>Background</h4>Enhanced coronary vasomotion may contribute to acute coronary occlusion during the acute phase of myocardial infarction (AMI). Japanese have a higher incidence of variant angina than Caucasian patients, but racial differences in vasomotor reactivity early after AMI are controversial.<h4>Methods and results</h4>The same team studied 15 Japanese and 19 Caucasian patients within 14 days of AMI by acetylcholine injection into non-infarct-related (NIRA) and infarct-related (IRA) coronary arteries followed by nitroglycerin. Incidence of vasodilation, vasoconstriction, spasm, and basal tone were assessed in proximal, middle, and distal segments after each drug bolus by quantitative angiography. Japanese patients had much lower cholesterol levels than Caucasians (183+/-59 versus 247+/-53 mg/dL, P<0.006) but showed a lower incidence of vasodilation (2% versus 9% of coronary segments) and a greater incidence of spasm after acetylcholine (47% versus 15% of arteries, P<0.00001). Incidence of spasm was higher in IRAs than in NIRAs in both populations (67% versus 39% and 23% versus 11%, respectively). Multivessel spasm was more common (64% versus 17%, P<0.02) and vasoconstriction of nonspastic segments was greater in Japanese patients (-23.4+/-14.9% versus -20.1+/-15.7%, P<0.02) in the presence of similar average basal coronary tone with respect to post-nitroglycerin dilation and of nonsignificant differences of coronary atherosclerotic score.<h4>Conclusions</h4>Soon after AMI, Japanese patients exhibited a 3-fold-greater incidence of spasm and greater vasoconstriction of nonspastic segments after acetylcholine than Caucasians. The causes of such differences warrant further investigation because they may have relevant pathophysiological and therapeutic implications. |
Keywords: | Vasomotor System Humans Coronary Vasospasm Myocardial Infarction Arteriosclerosis Acetylcholine Angiography Incidence Vasoconstriction Aged Middle Aged Japan Italy Female Male Asian People White People |
Rights: | © 2000 American Heart Association, Inc. |
DOI: | 10.1161/01.CIR.101.10.1102 |
Published version: | http://www.circ.ahajournals.org/cgi/content/abstract/101/10/1102 |
Appears in Collections: | Aurora harvest 4 Medicine publications |
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