期刊
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY
卷 40, 期 12, 页码 3015-3021出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/ATVBAHA.120.314260
关键词
acetylcholine; cardiomyocyte injury; coronary artery disease; INOCA; myocardial ischemia; risk; troponin I; vascular function
资金
- American Heart Association Postdoctoral Fellowship Award Grant [18POST34080330]
- National Heart, Lung, and Blood Institutes [N01-HV-68161, N01-HV-68162, N01-HV-68163, N01-HV-68164]
- National Institute on Aging [U0164829, U01 HL649141, U01 HL649241, K23HL105787, T32HL69751, R01 HL090957, 1R03AG032631]
- GCRC grant from the National Center for Research Resources [M01RR00425]
- National Center for Advancing Translational Sciences [UL1TR000124, UL1TR001427]
- Edythe L. Broad and the Constance Austin Women's Heart Research Fellowships
- Cedars-Sinai Medical Center, Los Angeles, California
- Barbra Streisand Women's Cardiovascular Research and Education Program
- CedarsSinai Medical Center, Los Angeles
- The Linda Joy Pollin Women's Heart Health Program
- Erika Glazer Women's Heart Health Project, Cedars-Sinai Medical Center, Los Angeles, California
OBJECTIVE: Women with symptoms or signs of myocardial ischemia but no obstructive coronary artery disease (INOCA) often have coronary vascular dysfunction and elevated risk for adverse cardiovascular events. We hypothesized that u-hscTnI (ultra-high-sensitivity cardiac troponin I), a sensitive indicator of ischemic cardiomyocyte injury, is associated with coronary vascular dysfunction in women with INOCA. Approach and Results: Women (N=263) with INOCA enrolled in the WISE-CVD study (Women's Ischemic Syndrome Evaluation-Coronary Vascular Dysfunction) underwent invasive coronary vascular function testing and u-hscTnI measurements (Simoa HD-1 Analyzer; Quanterix Corporation, Lexington, MA). Logistic regression models, adjusted for traditional cardiovascular risk factors were used to evaluate associations between u-hscTnI and coronary vascular function. Women with coronary vascular dysfunction (microvascular constriction and limited coronary epicardial dilation) had higher plasma u-hscTnI levels (both P=0.001). u-hscTnI levels were associated with microvascular constriction (odds ratio, 1.38 per doubling of u-hscTnI [95% CI, 1.03-1.84]; P=0.033) and limited coronary epicardial dilation (odds ratio, 1.37 per doubling of u-hscTnI [95% CI, 1.04-1.81]; P=0.026). u-hscTnI levels were not associated with microvascular dilation or coronary epicardial constriction. Conclusions: Our findings indicate that higher u-hscTnI is associated with coronary vascular dysfunction in women with INOCA. This suggests that ischemic cardiomyocyte injury in the setting of coronary vascular dysfunction has the potential to contribute to adverse cardiovascular outcomes observed in these women. Additional studies are needed to confirm and investigate mechanisms underlying these findings in INOCA. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00832702. GRAPHIC ABSTRACT: A graphic abstract is available for this article.
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