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Gender features of diagnosis non-obstructive coronary artery disease and factors associated with its detection

Authors: Korok E.V., Sumin A.N., Barbarash L.S.

Company: Research Institute for Complex Issues of Cardiovascular Diseases; Sosnovyy bulvar, 6, Kemerovo, 650002, Russian Federation

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Type:  Original study


DOI: https://doi.org/10.15275/kreatkard.2016.02.04

For citation: Korok E.V., Sumin A.N., Barbarash L.S. Gender features of diagnosis non-obstructive coronary heart disease and factors associated with its detection. Kreativnaya Kardiologiya. 2016; 10 (2): 136-149 (in Russian)

Keywords: gender features nonobstructive coronary artery disease coronary angiography

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Abstract

Objective. To study gender-specific diagnostics obstructive coronary artery disease (CAD) and factors associated with its detection during routine coronary angiography (CAG).

Material and methods. The retrospective study included 711 medical records of patients undergoing routine CAG. According to the gender were formed 2 groups: women (n=264, 63 [57; 66] years) and male (n=447, 60 [55; 67] years).

Results. Myocardial infarction (MI) in history was dominated by the men (p<0.001), left ventricular ejection fraction (LV EF) was higher in women (p<0,001). Patients with suspected CAD and valvular heart diseases (VHD) prevailed among women (p=0.001), and previous MI – among men (p<0.001). The lesion of the peripheral arterial basins, rhythm and conduction disturbances (RCD) did not differ between groups. The absence of coronary artery (CA) lesions often can be found among women (p<0.001) and significant stenosis of CA – in men (p<0.001). Typical and atypical angina met with the same frequency in both groups, and cardialgia – more common in women (p=0.004). Pretest probability of CAD was higher in males (p<0.001).

Independent predictors of intact CA in women is the presence RCD and cardialgia and increasing age, the presence of diabetes and angina increased the risk of atherosclerotic coronary lesions (p<0.05). With the absence of CA stenosis in men associated VHD, RCD, atypical angina and cardialgia, though the presence of typical angina, diabetes, decreased LV EF reduced probability of detecting intact CA (p<0.05).

Conclusion. According to the CAG nonobstructive coronary artery disease were detected in 61% of women and 37.3% of men, no damage CA – at 49.6 and 23%. Patients with suspected CAD and VHD prevailed among women, and patients with a history of MI – in men. Thus factors associated with detection of intact CA in CAG in patients of both sexes were the presence of RCD, cardialgia; and in men – the presence of VHD, atypical angina and increase of LV EF.

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About Authors

  • Korok Ekaterina Viktorovna, MD, PhD, Research Associate;
  • Sumin Aleksey Nikolaevich, MD, DM, Chief of Department;
  • Barbarash Leonid Semenovich, Academician of Russian Academy of Sciences, Chief Research Associate

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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