Coronary Plaque Characteristics and Cut-Off Stenosis for Developing Spasm in Patients with Vasospastic Angina.

Coronary plaque distribution, frequency and cut-off value of percent stenosis for developing vasospasm are uncertain in patients with vasospastic angina (VA). We enrolled 2960 patients who received coronary angiography (CAG) and ergonovine provocation test prospectively in 11 university hospitals in Korea. A total of 1836 patients with VA and 867 without VA were included. Plaque and % stenosis were defined as ≥1% luminal narrowing and mean of each segmental stenosis. Overall frequency of plaque and % diameter stenosis was compared among VA-patients with index coronary spasm positive, those with index arterial spasm negative/other arterial spasm positive (INOP) and non-VA patients. Diameter stenosis associated with the spasm positivity was investigated. Overall plaque frequency and % stenosis were higher in VA patients than non-VA patients. Plaque frequency was 27.6% (243/881) in spasm positive at LAD, 16.4% (157/955) in LAD INOP and 12.6% (109/867) in non-VA with statistic difference (P < 0.001). Same trend for higher rate was observed in LCx and RCA. For % stenosis, 36.6 vs 32.4% (p = 0.010) in LAD, 36.1 vs. 28% (p < 0.001) in LCx and 35.3 vs.30.0% (p = 0.047) in RCA, respectively. Diameter stenosis of LAD with spasm positive vs. LAD INOP vs. non-VA were 38.3%, 34.0%, 32% (P = 0.002) with similar pattern in LCx and RCA. By multivariate logistic regression analysis, coronary stenosis of LAD ≥ 35% or LCx ≥35% or RCA ≥ 40% were independent predictor of developing spasm (OR 2.019, 95% CI 1.315-3.100, P = 0.001). In conclusions, spastic coronary artery had more plaque frequency, higher % stenosis than in non-spastic coronary in VA patients. The spasm related and unrelated coronary in VA patients had more plaque than in matched and unmatched coronary arteries in non-VA patients. Coronary stenosis ≥35% in LAD and LCx was an independent predictor of developing spasm.

Does suicidal ideation and depressive mood of parents affect their adolescent children's mental health?

BACKGROUND: Depression in adolescence is a social problem that has detrimental effects on an individual's physical and mental health and increases health care burden on families and society. This study investigates the connection between mental illness among parents and their adolescent children in Korea. METHODS: The sample included parents of 5315 adolescents (12-24 years) and data were obtained from the Korea National Health and Nutrition Survey (KNHANES) from 2007 to 2017. Family based comprehensive questionnaires were used. Multivariate logistic regression models were performed to estimate odds ratios (ORs) at 95% confidence intervals (95% CIs). RESULTS: The main findings showed that daughters with depressed mothers were 1.92 times more likely to experience depression and 1.64 times more likely to have suicidal ideations. In particular, when father was suicidal, his daughter had a 2.59 times higher risk of suicidal thoughts than father was not depressed and had no suicidal thoughts. Sons' depressive mood was rarely affected by the psychological status of mothers and fathers. LIMITATION: There are under-report issue of feelings and study design is cross-sectional. CONCLUSIONS: This study showed gender differences in the association between parents' and adolescents' experience of depression. Thus, the daughter's psychological state was found to be strongly associated with the psychological state of both parents.