Endothelial dysfunction, increased carotid artery intima-media thickness and pulse wave velocity, and increased level of inflammatory markers are associated with variant angina

Summary Background Endothelial dysfunction and vascular inflammation may be associated with variant angina (VA). Flow-mediated vasodilation (FMD), carotid artery intima-media thickness (IMT), and pulse wave velocity (PWV) are widely used as non-invasive modalities for evaluating atherosclerosis. Methods and results A total of 254 patients with chest pain were divided into three groups according to coronary angiogram (CAG) finding. There were 76 patients (VA group: 53.5 ± 10.2 years, 41 males) with normal CAG with positive ergonovine-provocation test (EPT), 58 patients (control group: 55.3 ± 8.7 years, 30 males) with normal CAG with negative EPT, and 120 patients with angiographically diagnosed coronary artery disease (CAD group: 56.3 ± 9.7 years, 79 males). The level of FMD was lower in the VA group than in the control group (7.7 ± 3.5% vs. 9.4 ± 3.8%, p = 0.014). Carotid IMT was higher in the VA group than in the control group (0.58 ± 0.1 mm vs. 0.54 ± 0.1 mm, p = 0.029). The brachial-ankle PWV (baPWV) was higher in the VA group than in the control group (1445.3 ± 211.8 cm/s vs. 1396.7 ± 394.5 cm/s, p = 0.020). The levels of monocyte cell counts was higher in patients of the VA group than in the other two groups (7545.7 ± 2611.1/mm3 vs. 6548.2 ± 2156.4/mm3 vs. 6740.9 ± 1730.4/mm3 , p = 0.015, respectively; monocyte cell counts: 657.2 ± 242.6/mm3 vs. 442.5 ± 219.3/mm3 vs. 490.0 ± 172.0/mm3 , p = 0.025). Conclusion VA is associated with endothelial dysfunction and increased carotid IMT, baPWV, and inflammatory markers.