Juraj Hrnčiar, Mária Hrnčiarová, Gabriela Kaliská, František Kovář, Jarmila Okapcová
Microvascular angina pectoris was found in 70 out of 500 patients indicated for coronarography (14 %). In more than half cases thalium SPECT scintigram of the myocardium confirmed perfusion defects in myocardium and android obese, benign hirsute, premenopausal women prevailed 4.1 times. There was no significant difference between patients with microvascular angina pectoris and those with coronary stenoses when probands of the same BMI, age and sex, overweight and obesity (94 %), hypertension (76 %), dyslipoproteinemia (75 %), DM 2 (36 %) and further disglycemias were compared. All phenomena of insulin resistance syndrome significantly corelated with values of immunoreactive insulin or with calculated insulin sensitivity indices (HOMA, FIRI, Quicki a NISI) despite the level of whole cholesterol and fibrinogen. The highest correlations were found in HDL, TAG, ApoB/ApoA1, BMI, PAI-1 and in confirmed quantitative coronary score, expressing the number and stage of confirmed coronary stenoses. Microvascular angina pectoris is neither rare nor minor disease. It is determined by dysfunction of vascular endothelium of coronary arteriols. It is manifestation of early stage of atherothrombogenesis with high aggregation of risk factors expressed like phenomena of metabolic syndrome that have to be treated by early non pharmacological and pharmacological intervention. Hormone replacement therapy with sexagens in premanopausal women was not confirmed for prevention and treatment of ICHS and microvascular angina pectoris because high risks and costly treatment prevail benefits.