Key result
In young women with premature ischemic heart disease, a history of migraines was independently associated with a significantly higher odds of having vasomotor (M)INOCA compared to obstructive CAD (OR 6.84).
Why the study?
Heart disease is the leading cause of premature death for women in Canada, but the prevalence and relationships of traditional and non-traditional risk factors in young women with (M)INOCA compared to obstructive CAD remain to be determined.
Do non-traditional and sex-specific risk factors differ in prevalence between young women with premature (M)INOCA versus obstructive CAD?
Observational (n=254)
Yes
Do non-traditional and sex-specific risk factors differ in prevalence between young women with premature (M)INOCA versus obstructive CAD?
Young women with premature (M)INOCA have a distinct risk factor profile characterized by non-traditional factors like migraines and preeclampsia, contrasting with the traditional risk factors seen in obstructive CAD.
Answers are grounded in this paper and cite their sources.
Observational data on IHD risk factors in Canadian women leaves open questions on targeted prevention; prospective studies needed before practice change.
Background Heart disease is the leading cause of premature death for women in Canada. Ischemic heart disease (IHD) 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 non-traditional IHD risk factors and their relationships with (M)INOCA compared to MI-CAD and non-MI CAD in young women. Methods This study investigated women who presented with premature (≤55 years old) vasomotor entities of (M)INOCA or obstructive CAD confirmed by coronary angiography, who are currently enrolled in either the Leslie Diamond Women’s Heart Health Clinic Registry (WHC) or the Study to Avoid cardioVascular Events in BC (SAVEBC). Univariable and multivariable regression models were applied to investigate associations of risk factors with odds of (M)INOCA, MI-CAD or non-MI CAD. Results A total of 254 women enrolled between 2015-2022 were analyzed: 77 INOCA and 37 MINOCA from the WHC and 66 with non-MI CAD and 74 MI-CAD from SAVEBC. Regression analyses demonstrated that migraines and preeclampsia/gestational hypertension were the most significant risk factors with higher likelihood to associate with premature (M)INOCA relative to obstructive CAD. Conversely, the presence of diabetes and a current or previous smoking history had the highest likelihood to associate with premature CAD. Conclusion There are significant differences in the risk factor profiles of patients with premature (M)INOCA compared to obstructive CAD.
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Théberge et al. (2023) conducted an observational in Premature ischemic heart disease ((M)INOCA vs obstructive CAD) (n=254). History of migraines vs. No history of migraines was evaluated on Odds of (M)INOCA compared to obstructive CAD (OR 6.84, 95% CI 2.56-21.74, p=<0.001). In young women with premature ischemic heart disease, a history of migraines was independently associated with a significantly higher odds of having vasomotor (M)INOCA compared to obstructive CAD (OR 6.84).
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