Key result
Migraine history is linked to ~6.8-fold higher odds of premature (M)INOCA versus obstructive CAD.
Why the study?
Heart disease is the leading cause of premature death for women in Canada, prompting study into the prevalence of traditional and nontraditional risk factors and their relationships with (M)INOCA versus obstructive CAD in young women.
Are nontraditional and sex-specific risk factors more strongly associated with premature (M)INOCA than traditional risk factors in young women compared to obstructive CAD?
Cohort (n=254)
Yes
Are nontraditional and sex-specific risk factors more strongly associated with premature (M)INOCA than traditional risk factors in young women compared to obstructive CAD?
Answers are grounded in this paper and cite their sources.
The study highlights that premature (M)INOCA in young women is strongly driven by nontraditional and sex-specific risk factors like migraines and preeclampsia, presenting a distinct risk profile from traditional obstructive CAD.
Background: Heart disease is the leading cause of premature death for women in Canada. Ischemic heart disease is categorized as myocardial infarction (MI) with no obstructive coronary artery disease (MINOCA), ischemia with no obstructive coronary arteries (INOCA), and atherosclerotic obstructive coronary artery disease (CAD) with MI (MI-CAD) or without MI (non-MI-CAD). This study aims to study the prevalence of traditional and nontraditional ischemic heart disease risk factors and their relationships with (M)INOCA, compared to MI-CAD and non-MI-CAD in young women. Methods: olumbia (SAVEBC). Univariable and multivariable regression models were applied to investigate associations of risk factors with odds of (M)INOCA, MI-CAD, and non-MI-CAD. Results: A total of 254 women enrolled between 2015 and 2022 were analyzed, as follows: 77 with INOCA and 37 with MINOCA from the registry, and 66 with non-MI-CAD and 74 with MI-CAD from the study. Regression analyses demonstrated that migraines and preeclampsia or gestational hypertension were the most significant risk factors, with a higher likelihood of being associated with premature (M)INOCA, relative to obstructive CAD. Conversely, the presence of diabetes and a current or previous smoking history had the highest likelihood of being associated with premature CAD. Conclusions: The risk factor profiles of patients with premature (M)INOCA, compared to obstructive CAD, have significant differences.
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Théberge et al. (2023) conducted a cohort in (M)INOCA vs Obstructive CAD (n=254). Migraines vs. No migraines was evaluated on Diagnosis of premature (M)INOCA relative to obstructive CAD (OR 6.84, 95% CI 2.56-21.74, p=<0.001). A history of migraines was independently associated with a significantly higher likelihood of having premature (M)INOCA relative to obstructive CAD (adjusted OR 6.84).
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