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American Heart Association

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Final ID: 4142037

Age Differences in Patients with Ischemia and Nonobstructive Coronary Arteries

Abstract Body (Do not enter title and authors here): Introduction: Ischemia and nonobstructive coronary arteries (INOCA) is increasingly recognized and encompasses vasomotor disorders such as coronary microvascular dysfunction (CMD) and vasospastic angina (VA). The prevalence of atherosclerotic coronary artery disease increases with age, but the age at the time of diagnosis in patients with INOCA is not well described.
Methods: From 2017 to 2024, 221 patients with INOCA underwent invasive coronary physiologic assessment including vasoreactivity testing with acetylcholine provocation, guidewire-based assessment of coronary flow reserve (CFR), index of microcirculatory resistance (IMR), and fractional flow reserve (FFR). Age cut-off of 60 years was selected to create two groups of adequate size.
Results: Mean age was 57.7 ± 10.8 years and 158 (71.5%) were females. Older INOCA patients (>60 years old) had higher rates of hypertension and obstructive sleep apnea, but similar rates of hyperlipidemia, diabetes, depression, anxiety, and active smoking compared to younger patients (<60 years old). There were significant differences in medical therapy at baseline with older patients being more likely to receive statin (69.7% vs 54.9%, p=0.024), ACEi/ARB (35.4% vs. 22.1%, p=0.029), or β-blockers (50.5% vs. 35.3%, p=0.022). Increasing age was associated with progressive decrease in CFR (rho=-0.21; R2= 0.04; p<0.001), and a progressive increase in IMR (rho=0.35; R2= 0.12; p=0.002) (Figure 1). Older INOCA patients had higher rates of CMD (38.4% vs. 21.3%; p=0.005), and myocardial bridging was more frequent in younger patients (14.8% vs. 5.1%; p=0.015) (Figure 2).
Conclusion: In our study sample, increasing age was associated with a reduction in CFR and increase in IMR. Older INOCA patients were more likely to have CMD and less likely to have myocardial bridging compared to younger patients.
  • Kostantinis, Spyridon  ( YALE SCHOOL OF MEDICINE , Fairfield , Connecticut , United States )
  • García Castro, Gabriel  ( YALE SCHOOL OF MEDICINE , Fairfield , Connecticut , United States )
  • Latif, Nida  ( YALE SCHOOL OF MEDICINE , Fairfield , Connecticut , United States )
  • Cigarroa, Natasha  ( YALE SCHOOL OF MEDICINE , Fairfield , Connecticut , United States )
  • Kunnirickal, Steffne  ( YALE SCHOOL OF MEDICINE , Fairfield , Connecticut , United States )
  • Odanovic, Natalija  ( Institute for Cardiovascular Diseases "Dedinje" , Belgrade , Serbia )
  • Shah, Samit  ( YALE SCHOOL OF MEDICINE , Fairfield , Connecticut , United States )
  • Author Disclosures:
    Spyridon Kostantinis: DO NOT have relevant financial relationships | Gabriel García Castro: DO NOT have relevant financial relationships | Nida Latif: DO NOT have relevant financial relationships | Natasha Cigarroa: DO NOT have relevant financial relationships | Steffne Kunnirickal: No Answer | Natalija Odanovic: DO NOT have relevant financial relationships | Samit Shah: DO have relevant financial relationships ; Research Funding (PI or named investigator):Abbott Vascular:Active (exists now)
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:
More abstracts from these authors:
Association Between Diabetes Mellitus and Angina With Nonobstructive Coronary Arteries

Latif Nida, Cigarroa Natasha, Kostantinis Spyridon, García Castro Gabriel, Kunnirickal Steffne, Odanovic Natalija, Shah Samit

Prevalence of Standard Modifiable Risk Factors in Patients with Ischemia and Nonobstructive Coronary Arteries

Kostantinis Spyridon, García Castro Gabriel, Latif Nida, Nikolakopoulos Ilias, Cigarroa Natasha, Kunnirickal Steffne, Odanovic Natalija, Shah Samit

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