Sex-specific differences in the anatomical localization and severity of coronary artery disease: differential impact of conventional cardiovascular risk factors.

IF 2.4

Clinics (Sao Paulo, Brazil) Pub Date : 2026-09-15 DOI:10.1016/j.clinsp.2026.101149

Nurgül Keser, Yetkin Korkmaz, Selami Doğan, Mehmet Şeker, Samet Yavuz, Mert Babaoğlu, Almina Erdem, İrem Yılmaz, Mustafa Oğuz, Akın Torun, Lutfullah Orhan, Mehmet Uzun

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Abstract

Background: Sex differences in coronary artery disease (CAD) are well recognized. Whether conventional cardiovascular risk factors (CVRFs) exert differential effects on anatomical localization and stenosis severity on coronary arteries (CA) remains uncertain. We aimed to evaluate sex-specific associations between major CVRFs and CA involvement.

Methods: We analyzed 978 patients undergoing coronary angiography (CAG) between 2017-2023. Sex, age, hypertension (HT), diabetes mellitus (DM), history of CAD (HCAD), smoking, Syntax scores (SS), lipid parameters and creatinine levels were assessed. Segment-based coronary involvement was evaluated using correlation and multivariable regression analyses.

Results: Women were older (p < 0.001), had higher rates of HT (p = 0.001), DM (p = 0.026) and higher total cholesterol (p = 0.001), LDL-C (p = 0.001) and HDL-C levels (p = 0.001). In contrast HCAD (p = 0.001), smoking (p = 0.009) and SS (p < 0,01) were higher in men. HT was associated with circumflex (Cx) (p = 0.029) and right coronary artery (RCA) (p = 0.002) involvement in women; with proximal left anterior descending artery (LAD) (p = 0.024) involvement in men. DM showed significant associations with LAD (p = 0.001), 1st diagonal (Dg) (p = 0.003), Cx: (p = 0.001) and RCA (p = 0.001) territories in women. HCAD was associated with proximal LAD (p = 0.013), CX (p = 0.006) and RCA (p = 0.016) in men; proximal LAD (p = 0.047), CX (p = 0.014) and RCA (p = 0.009) in women. Lipid parameters had no association with CA involvement in either sex after adjustment. Creatinine levels were associated with RCA and CX involvement in women and with LMCA and proximal LAD territories in men.

Conclusion: CVRFs exert sex-specific effects on CA, highlighting the importance of sex aware risk stratification in CAD.

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冠状动脉疾病解剖定位和严重程度的性别差异：传统心血管危险因素的差异影响

背景：冠状动脉疾病（CAD）的性别差异是公认的。传统的心血管危险因素（CVRFs）是否对冠状动脉（CA）的解剖定位和狭窄程度有不同的影响尚不确定。我们的目的是评估主要cvrf和CA受累之间的性别特异性关联。方法：我们分析了2017-2023年间接受冠状动脉造影（CAG）的978例患者。评估性别、年龄、高血压（HT）、糖尿病（DM）、CAD史（HCAD）、吸烟、句法评分（SS）、血脂参数和肌酐水平。使用相关和多变量回归分析评估基于节段的冠状动脉受累。结果：女性年龄较大（p < 0.001）， HT （p = 0.001）、DM （p = 0.026）发生率较高，总胆固醇（p = 0.001）、LDL-C （p = 0.001）和HDL-C水平较高（p = 0.001）。相比之下，HCAD （p = 0.001）、吸烟（p = 0.009）和SS （p < 0.01）在男性中较高。女性HT与旋冠（Cx）（p = 0.029）和右冠状动脉（RCA）（p = 0.002）受累相关；男性左前降支近端（LAD）受累（p = 0.024）。DM与女性的LAD （p = 0.001）、第1对角线（Dg）（p = 0.003）、Cx （p = 0.001）和RCA （p = 0.001）区域有显著相关性。HCAD与男性近端LAD （p = 0.013）、CX （p = 0.006）和RCA （p = 0.016）相关；女性近端LAD （p = 0.047）、CX （p = 0.014）和RCA （p = 0.009）。调整后，脂质参数与两性CA的发生无关联。肌酐水平与女性RCA和CX受累有关，与男性LMCA和LAD近端区域有关。结论：cvrf对CA具有性别特异性作用，强调了性别意识风险分层在CAD中的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Clinics (Sao Paulo, Brazil)

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