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Gender differences in patients presenting with premature coronary artery disease
Thamir M Al-Khlaiwi1, Syed S Habib1, Hessah F Alshammari2
1Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Insights
Male patients exhibit more severe coronary artery disease based on the Gensini score, while females show more anterior ST elevation. Left main artery occlusion is also more common in males with premature coronary artery disease (PCAD).
Area of Science:
- Cardiology
- Vascular Medicine
- Medical Research
Background:
- Premature coronary artery disease (PCAD) affects younger individuals, presenting unique challenges in diagnosis and management.
- Understanding gender-specific differences in PCAD manifestations is crucial for tailored clinical approaches.
- Existing research highlights potential disparities, necessitating further investigation into disease severity and presentation patterns between sexes.
Purpose of the Study:
- To investigate and compare gender-specific differences in the severity and clinical manifestations of premature coronary artery disease (PCAD).
- To analyze demographic, biomarker, and angiographic data to identify distinct patterns in male and female PCAD patients.
- To evaluate the correlation between gender and specific coronary artery disease markers like Gensini and vessel scores.
Main Methods:
- A retrospective analysis of patient data from King Khaled University Hospital (KKUH) between 2015 and 2022.
- Inclusion of demographic details, chemical biomarkers, and coronary angiography findings for PCAD patients.
- Calculation of Gensini and vessel scores using angiographic reports to quantify disease severity.
Main Results:
- Males demonstrated significantly higher Gensini scores (>39) compared to females (53.5% vs. 39.5%, P=0.021), indicating more severe disease.
- Females experienced more frequent anterior ST elevation on electrocardiography (ECG) compared to males.
- While both genders had similar rates of two- or three-vessel occlusions (57.4% males vs. 58.2% females, P=0.150), left main artery occlusion was more prevalent in males (approx. 8%) than females (3.5%).
Conclusions:
- Male patients with PCAD generally present with more severe coronary artery disease, as indicated by higher Gensini scores and a greater incidence of left main artery occlusion.
- Electrocardiographic findings reveal a higher prevalence of anterior ST elevation in female PCAD patients.
- Age distribution shows a peak incidence of PCAD between 45-50 years, with a more pronounced effect in females, while younger age groups show higher male prevalence.
Objectives:
To study gender differences according to severity and manifestations in patients presenting with premature coronary artery disease (PCAD).
Methods:
In this retrospective study, patients' information, including demographic data, chemical biomarkers, and coronary angiography findings, was obtained from the electronic system at King Khaled University Hospital (KKUH), Riyadh, Saudi Arabia, during the period between 2015 and 2022. Gensini and vessel scores were calculated from patients' angiographic reports.
Results:
Among males, 53.5% of the subjects had a Gensini score of > 39; only 39.5% of females had such a Gensini score (P = 0.021). Electrocardiography (ECG) changes revealed more frequent ST elevation in the anterior leads among females than among males. According to the vessel score, 57.4% of males and 58.2% of females had two- or three-vessel occlusions (P = 0.150). Approximately 8% of male patients and 3.5% of female patients had left main artery occlusion. The 45-50 years age group was associated with a higher rate of PCAD development, and this effect was more pronounced among females than among males, while in younger age groups, males were higher than females.
Conclusions:
Male patients had more severe vessel occlusion than female patients according to the Gensini score, while anterior ST elevation is more prominent in females. More than 8% of the male patients had left main artery occlusion compared to 3.5% of the female patients who had main artery occlusions.
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