Gender Differences in Patients With Stable Chest Pain.

Area of Science:

• Cardiovascular Medicine
• Radiology
• Medical Imaging

Background:

• Chest pain is a common symptom requiring accurate diagnosis of coronary artery disease (CAD).
• Gender-related differences in cardiovascular disease presentation and outcomes are increasingly recognized.
• Coronary computed tomography angiography (CCTA) is a key imaging modality for evaluating chest pain in outpatient settings.

Purpose of the Study:

• To investigate gender disparities in clinical presentation of chest pain.
• To compare the presence and extent of coronary artery disease (CAD) between men and women using CCTA.
• To analyze gender differences in all-cause mortality among patients with stable chest pain.

Main Methods:

• Retrospective analysis of 1,835 patients (966 female) undergoing CCTA for stable chest pain.
• Comparison of clinical characteristics, CAD prevalence, coronary artery calcium scores, and survival between men and women.
• Logistic and Cox regression models were used to identify risk factors for CAD and all-cause mortality, respectively.

Main Results:

• Women reported less typical chest pain compared to men (22.8% vs 31.1%).
• Significant CAD was less prevalent in women (22.2%) than in men (38.1%), with lower coronary artery calcium scores.
• Male sex was independently associated with higher all-cause mortality (aHR 1.87), while women consistently showed a better prognosis, irrespective of pain type.

Conclusions:

• Significant gender-related differences exist in chest pain presentation, CCTA findings, and prognosis.
• Women with chest pain exhibit less coronary artery disease and a more favorable outcome compared to men.
• Further research is warranted to understand the clinical implications of these observed gender disparities in CAD management.