Chonnam Med J.  2011 Apr;47(1):14-19. 10.4068/cmj.2011.47.1.14.

Diagnostic Value of Nitroglycerin-Induced Headache as a Negative Predictor of Coronary Atherosclerosis

• Cho SH
• Jeong MH
• Sim DS
• Hong YJ
• Park HW
• Kim JH
• Ahn Y
• Cho JG
• Park JC
• Kang JC

• KMID: 2172237
• DOI: http://doi.org/10.4068/cmj.2011.47.1.14

Abstract

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+/-9.5 years, 52 males) and 204 patients without headache (group II: 58.1+/-9.1 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+/-4.1% vs. 7.1+/-3.5%, p=0.001, and 23.1+/-7.3% vs. 17.1+/-11.8%, p<0.001, respectively). The carotid intima-media thickness was significantly smaller in group I than in group II (0.55+/-0.15 mm vs. 0.67+/-0.22 mm, p=0.001). Heart-carotid pulse wave velocity was significantly lower in group I than in group II (784.5+/-160.1 m/s vs. 979.1+/-215.6 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.

Keyword

Coronary artery disease; Endothelium; Nitroglycerin

MeSH Terms

Atherosclerosis
Carotid Intima-Media Thickness
Chest Pain
Coronary Artery Disease
Coronary Vessels
Endothelium
Headache
Humans
Nitroglycerin
Pulse Wave Analysis
Nitroglycerin

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