GENDER DIFFERENCES IN CORONARY ARTERY DISEASE PRESENTATION AND OUTCOMES IN PAKISTAN: FOCUS ON LAD, LCX, AND LMS
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Keywords
Coronary Artery Disease, hypertension, morbidity and mortality, MACE, LAD, LCX, and LMS
Abstract
Background: Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide, with significant variations based on demographic factors such as age, sex, and ethnicity. In Pakistan, CAD is a major health burden with increasing prevalence and risk factors like hypertension, diabetes, and smoking.
Objective: This study aimed to investigate gender differences in the presentation and outcomes of CAD in the Pakistani population, focusing on the left anterior descending artery (LAD), left circumflex artery (LCX), and left main stem (LMS) arteries.
Methods: An observational cross-sectional study was conducted at the National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan, from January 2022 to December 2022. The study included 500 participants (300 males, 200 females) diagnosed with CAD and who underwent coronary angiography. Data collection included demographic information, clinical history, risk factors, and angiographic findings. Primary outcomes were the severity and location of coronary artery stenosis, and secondary outcomes included in-hospital mortality and major adverse cardiovascular events (MACE). Statistical analysis was performed using SPSS software version 25.0, with multivariate logistic regression used to identify independent predictors of severe stenosis and adverse outcomes.
Results: The mean age of participants was 55.3 years (SD = 10.5). Males exhibited higher rates of hypertension (70% vs. 55%), diabetes (47% vs. 45%), and smoking (43% vs. 10%) compared to females. Severe stenosis in the LAD was more common in males (70%) than females (50%). Females had a higher in-hospital mortality rate (12%) compared to males (8%), though not statistically significant. However, MACE occurrence was significantly higher in males (20%) compared to females (12%) (p<0.05). Multivariate logistic regression identified age, hypertension, diabetes, and smoking as significant predictors of severe stenosis and adverse outcomes.
Conclusion: The study highlights significant gender differences in CAD presentation and outcomes in Pakistan, emphasizing the need for gender-specific management strategies. These findings can inform clinical practice and help reduce healthcare disparities in CAD management. Further research is needed to explore long-term outcomes and develop effective gender-specific interventions.
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