학술논문
Association between hormone therapy and short-term cardiovascular events in women with spontaneous coronary artery dissection.
Document Type
Academic Journal
Author
Mori R; Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.; Macaya F; Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain. Electronic address: fernando@macaya.eu.; Giacobbe F; Dipartimento di Cardiologia, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy.; Moreno V; Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.; Quadri G; Dipartimento di Cardiologia, San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, Rivoli, Turin, Italy.; Chipayo D; Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.; Bianco M; Dipartimento di Cardiologia, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy.; Salinas P; Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.; Rolfo C; Dipartimento di Cardiologia, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy.; Mejía-Rentería H; Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.; Boi A; Dipartimento di Cardiologia, Azienda Ospedaliera Brotzu, Cagliari, Italy.; Tirado-Conte G; Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.; Cavallino C; Dipartimento di Cardiologia, Sant'Andrea Hospital, Vercelli, Italy.; Nombela-Franco L; Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.; Cinconze S; Dipartimento di Cardiologia, Azienda Ospedaliera S Croce e Carle, Cuneo, Italy.; Jiménez-Quevedo P; Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.; Pavani M; Dipartimento di Cardiologia, Azienda Ospedaliera Brotzu, Cagliari, Italy.; Fernández-Ortiz A; Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.; Chinaglia A; Dipartimento di Cardiologia, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy.; Fuentes-Ferrer ME; Departamento de Medicina Preventiva, Unidad de soporte metodológico a la investigación, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.; Núñez-Gil IJ; Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.; Gonzalo N; Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.; Cerrato E; Dipartimento di Cardiologia, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy.; Varbella F; Dipartimento di Cardiologia, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy.; Escaned J; Departamento de Cardiología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.
Source
Publisher: Elsevier Doyma Country of Publication: Spain NLM ID: 101587954 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1885-5857 (Electronic) Linking ISSN: 18855857 NLM ISO Abbreviation: Rev Esp Cardiol (Engl Ed) Subsets: MEDLINE
Subject
Language
English; Spanish; Castilian
Abstract
Introduction and Objectives: Changes in sex hormone levels are a known triggering factor for spontaneous coronary artery dissection (SCAD) in women. However, it is unknown whether exposure to exogenous hormone therapy (HT) at the time of SCAD presentation modifies the clinical course of this condition. We investigated the association between HT in female patients presenting with SCAD and short-term clinical outcomes.
Methods: We enrolled consecutive patients presenting with SCAD from the DISCO-IT/SPA (dissezioni spontanee coronariche Italian-Spanish) registry. Women on HT (estrogens, progestagens, or gonadotropins) at the time of presentation were identified, and their clinical characteristics and short-term outcomes were compared with those not receiving active HT. The outcome measure was nonfatal myocardial infarction and/or unplanned percutaneous coronary intervention during the first 28 days after the index catheterization.
Results: Of 224 women presenting with SCAD (mean age 52.0±10.0 years), 39 (17.4%) were currently using HT while 185 (82.6%) were not. No significant differences were noted in the baseline demographics, clinical presentation, angiographic features, or initial treatment received between the 2 groups. All patients on systemic HT (n=36, 92%) discontinued it at the time of diagnosis. The composite outcome occurred in 7 (17.9%) patients with prior HT compared with 14 (7.6%) without (P=.039). After multivariable adjustment, HT remained associated with the composite outcome recorded in the first 28 days of follow-up (HR, 3.53; 95%CI, 1.30-9.61; P=.013).
Conclusions: In women with SCAD, exposure to HT at the time of clinical presentation was associated with short-term recurrent cardiovascular events such as nonfatal myocardial infarction and/or unplanned percutaneous revascularization.
(Copyright © 2023 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
Methods: We enrolled consecutive patients presenting with SCAD from the DISCO-IT/SPA (dissezioni spontanee coronariche Italian-Spanish) registry. Women on HT (estrogens, progestagens, or gonadotropins) at the time of presentation were identified, and their clinical characteristics and short-term outcomes were compared with those not receiving active HT. The outcome measure was nonfatal myocardial infarction and/or unplanned percutaneous coronary intervention during the first 28 days after the index catheterization.
Results: Of 224 women presenting with SCAD (mean age 52.0±10.0 years), 39 (17.4%) were currently using HT while 185 (82.6%) were not. No significant differences were noted in the baseline demographics, clinical presentation, angiographic features, or initial treatment received between the 2 groups. All patients on systemic HT (n=36, 92%) discontinued it at the time of diagnosis. The composite outcome occurred in 7 (17.9%) patients with prior HT compared with 14 (7.6%) without (P=.039). After multivariable adjustment, HT remained associated with the composite outcome recorded in the first 28 days of follow-up (HR, 3.53; 95%CI, 1.30-9.61; P=.013).
Conclusions: In women with SCAD, exposure to HT at the time of clinical presentation was associated with short-term recurrent cardiovascular events such as nonfatal myocardial infarction and/or unplanned percutaneous revascularization.
(Copyright © 2023 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)