KMID : 0880520110470010014
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Chonnam Medical Journal 2011 Volume.47 No. 1 p.14 ~ p.19
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Diagnostic Value of Nitroglycerin-Induced Headache as a Negative Predictor of Coronary Atherosclerosis
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Cho Sook-Hee
Jeong Myung-Ho Sim Doo-Sun Hong Young-Joon Park Hyung-Wook Kim Ju-Han Ahn Young-Keun Cho Jeong-Gwan Park Jong-Chun Kang Jung-Chaee
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Abstract
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The purpose of the present study was to clarify the possible relationship between nitroglycerin (NTG)-induced headache and both vascular functional and organic atherosclerosis. The study included 96 patients with NTG-induced headache (group I: 54.7¡¾9.5 years, 52 males) and 204 patients without headache (group II: 58.1¡¾9.1 years, 127 males) who suffered from new-onset chest pain. Flow-mediated dilation and nitroglycerin-mediated dilation were significantly greater in group I than in group II (8.8¡¾4.1% vs. 7.1¡¾3.5%, p=0.001, and 23.1¡¾7.3% vs. 17.1¡¾11.8%, p<0.001, respectively). The carotid intima-media thickness was significantly smaller in group I than in group II (0.55¡¾0.15 mm vs. 0.67¡¾0.22 mm, p=0.001). Heart-carotid pulse wave velocity was significantly lower in group I than in group II (784.5¡¾160.1 m/s vs. 979.1¡¾215.6 m/s, p=0.003). In the multiple regression analysis, the absence of NTG-induced headache was a predictor of coronary artery disease (CAD) (odds ratio: 17.89, 95% confidence interval: 7.89-40.02, p<0.001). NTG-induced headache developed more frequently in patients with normal coronary arteries or minimal CAD than in patients with obstructive CAD. The presence of NTG-induced headache might be helpful and provide additional information in evaluating patients with chest pain syndrome.
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KEYWORD
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Coronary artery disease, Endothelium, Nitroglycerin
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