Investigating Self-Rated Angina Severity by Migraine Status in Female Patients with Non-Obstructive Coronary Artery Syndromes

Myocardial infarction with non-obstructive coronary arteries (MINOCA) and ischemia with non-obstructive coronary arteries (INOCA) affect more women than men. Migraines may share an underlying pathophysiology with non-obstructive coronary syndromes through endothelial dysfunction. It is unclear how self-rated angina severity scores vary between patients with MINOCA and INOCA and how these associations differ by migraine status. This study included female patients enrolled in the Leslie Diamond Women’s Heart Health Clinic Registry in Vancouver, BC, with angiographically confirmed diagnoses of MINOCA or INOCA. The Seattle Angina Questionnaire (SAQ) was administered at recruitment baseline, measuring self-reported angina and depression, respectively. Student’s t-tests were employed to compare mean SAQ-7 scores between (M)INOCA groups and two-way ANOVAs were conducted to assess if migraine status associated with any differences seen within and between (M)INOCA groups. There were 224 patients identified with MINOCA (n=74, 33%) or INOCA (n=150, 67%). A history of migraines was reported in 75 (33%) patients, of which 32 (43%) had MINOCA and 43 (57%) had INOCA. Patients with INOCA reported significantly worse SAQ-7 summary scores than patients with MINOCA (mean=51.5 vs. 68.0, p<.001), and significantly worse SAQ-7 domain scores: physical limitation (mean=67.5 vs. 52.6, p<.001), angina frequency (mean=73.4 vs. 54.3, p<.001) and quality of life (mean=67.6 vs. 45.3, p=.001). There were no significant differences in the scores between migraine sufferers and non-migraine sufferers within and between (M)INOCA groups. Patients with INOCA report worse self-rated angina than MINOCA patients, however migraines do not associate with these differences.