Sex differences in clinical and coronary artery features of patients with premature coronary heart disease

AIM To evaluate sex differences in risk factors, clinical profiles, and coronary artery lesion in patients with premature coronary heart disease (PCHD). METHODS A total of 198 consecutive patients with premature CHD who were confirmed by coronary angiography with ≥50% luminal stenosis were divided into female group (F group, <55 years old, n=63) and male group (M group, <65 years old, n=135) from May 2009 to October 2014 in our department. Differences in CHD risk factors, clinical symptom and angiographic features between groups were observed and analyzed. RESULTS Compared to F group, the M group had a significantly higher prevalence of smoking (83 vs. 5%, P<0.01), obesity (28 vs. 16%, P<0.05), and alcohol consumption (39 vs. 2%, P<0.01); however, the F group showed a significantly higher rate of hypertension (70 vs. 51%, P<0.05). There were no significant differences in the prevalence rates of dyslipidemia, diabetes and number of risk factors between groups. M group shows a higher mean of serum triglycerides ［(2.0±1.4) mmol/L vs. (1.6±0.9) mmol/L, P<0.05］ and lower serum high-density lipoprotein cholesterol (HDL) cholesterol levels ［(1.03±0.23) mmol/L vs.(1.18±0.27) mmol/L, P<0.01］, lower apolipoprotein A ［(1.11±0.19) g/L vs.(1.20±0.23) g/L, P<0.01］, and apolipoprotein A/B ratio ［(1.4±0.5) vs.(1.6 ± 0.5), P<0.01］ than the F group. Traditional cardiovascular risk factor clustering in the M group is higher than in the F group ［(1.9±1.0) vs.(1.1 ± 0.8), P<0.01］. Laborers were the most common occupation in the two groups (50 vs. 40%); whereas the F group had a higher proportion of unemployment (12% vs. 30%, P<0.01). Absence of chest pain was noted commonly in the two groups (35 vs. 46%) but without differences between groups. Palpitations were the most frequent symptom in the F group (7 vs. 22%, P<0.01); however, the phenomenon of perspiration appeared more frequently in the M group (44 vs. 29%, P<0.05). Two groups showed no significant differences in angiographic findings in terms of the number of involved branches, severity of coronary lesion and ratio of patients who underwent PCI. CONCLUSION Some differences exist in clinical characteristics between female and male patients with premature coronary heart disease. Both sexes showed no significant differences in angiographic findings.