70 Chapter 4 Table 2. Cardiovascular risk factors in ANOCA patients with epicardial spasm in Western World and Asian populations Western World populations Asian Populations Total P value Number of patients 949 2771 2729 Age (mean years, 95% CI) 57 (54-65) 62.4 (59-64) 61 (59-63) 0.29 Women (%, 95% CI) 57 (29-82) 35 (24-47) 42 (31-55) 0.08 Hypertension (%, 95% CI) 50 (37-64) 45 (39-51) 47 (42-53) 0.37 Dyslipidaemia (%, 95% CI) 56 (42-70) 40 (27-55) 47 (37-57) <0.01 DM (%, 95% CI) 13 (7-24) 21 (17-26) 17 (14-22) <0.01 Smoking (%, 95% CI) 49 (31-67) 50 (35-65) 49 (39-60) 0.89 Seventeen studies examining cardiovascular risk factors from Western and Asian populations patients were included in this random effects meta-analysis. ANOCA, angina with no obstructive coronary arteries; DM, diabetes mellitus. Table 3. Clinical features in ANOCA patients with and without epicardial spasm ANOCA patients with ES (n=2721) %(95% CI) ANOCA patients without ES (n=3396) %(95% CI) Mean difference/OR (95% CI) & P Value Age (mean years) 61 (59 - 63) 60 (58 - 61) 1.14 (-0.18, 2.45), p=0.086 Women (%) 39% (29% - 50%) 53% (47%-59%) 0.56 (0.37,0.84), p=0.008 Hypertension (%) 53% (47%-59%) 49% (42%-56%) 0.90 (0.76, 1.07), p=0.214 Dyslipidaemia (%) 48% (38% - 58%) 42% (32%-53%) 1.23 (0.96,1.57), p=0.090 DM (%) 18% (14% -23%) 15% (13%-18%) 1.11 (0.94,1.3), p=0.211 Smoking (%) 49% (38%-60%) 34% (28%-41%) 2.01 (1.40, 2.88), p<0.001 Seventeen studies examining cardiovascular risk factors between ANOCA patients with and without epicardial spasm were included in this random effects meta-analysis. ANOCA, angina with no obstructive coronary arteries; CI, confidence interval; DM, diabetes mellitus; ES, epicardial spasm; OR, odds-ratio. Clinical characteristics of ANOCA patients with CAS Seventeen studies (n = 6.117) reported CV risk factors in patients with (n = 2.721) and without epicardial spasm (n = 3.396) (Table 3).8, 9, 12, 13, 16–20, 23–25, 27, 29–32 In the epicardial spasm group (49%; 95% CI, 38%–60%) smoking occurred significantly more often compared to patients without epicardial spasm (34%; 95% CI, 28%-41%) [OR 2.01 (1.40–2.88), p < 0.01] (Table 3). Other CV risk factors (i.e., hypertension, dyslipidaemia, diabetes mellitus) were similar between the two groups. Four studies reported clinical features for epicardial and microvascular spasm patients, which can be found in Supplementary Table S7.8, 9, 17, 24
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