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Smoking especially dangerous for individuals with gene that causes coronary artery spasm

ATLANTA, Nov. 10 -- Scientists in Japan may have found a genetic cause of coronary artery spasm, a condition that reduces blood supply to the heart causing chest pain or, in severe cases, even a heart attack. They reported their finding today at the American Heart Association Scientific Sessions.

A coronary artery spasm occurs when a coronary artery -- one of the blood vessels supplying blood to the heart -- constricts, then fails to re-open or dilate. Smoking can increase the risk for spasm, but the precise reason for coronary artery spasm has been largely unknown.

In genetic studies, researchers found that mutations in the endothelial nitric oxide synthase (eNOS) gene -- which controls nitric oxide production in the epithelium, or lining, of blood vessel walls -- were prevalent in patients with coronary artery spasm.

Nitric oxide is a key chemical in controlling blood vessel dilation. Varying levels of the chemical stimulate blood vessels to relax or constrict to meet the heart's increasing or decreasing demand for blood flow. "Given that the effects of the gene and smoking are potentially additive, individuals with the gene should be strongly cautioned against smoking," says Michihiro Yoshimura, M.D., Ph.D., and fellow researchers at Kumamoto University in Japan.

"In other studies, we found that nitric oxide activity was deficient in the coronary arteries of patients with coronary spasm," says Yoshimura, lead scientist on the study. "From there we decided to target the eNOS gene to find a genetic cause of coronary artery spasm."

In the study, Yoshimura and colleagues compared risk factors and genetic findings between 201 individuals diagnosed with coronary artery spasm and 345 healthy volunteers. The researchers revealed that the eNOS gene mutation is the most predictive risk factor for coronary artery spasm, followed by cigarette smoking.

Individuals with the gene mutation had twice the risk of having a spasm as
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Contact: Carole Bullock
caroleb@heart.org
214-706-1279
American Heart Association
9-Nov-1999


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