Abstract
Background
Extensive research has demonstrated the importance of traditional cardiovascular risk
factors in predicting acute coronary events. Our main objective was to evaluate the
relationship between traditional risk factors and the presence of obstructive coronary
artery disease (CAD), and to explore potential differences in men vs women.
Methods
An observational study was conducted in a population-based cohort of stable patients
who underwent cardiac catheterization in Ontario, Canada. We examined the relationship
of diabetes, hypertension, hyperlipidemia, and smoking with the presence of obstructive
CAD in men and women using multivariable logistic regression models.
Results
Of the 46,490 patients who were included in our study, 61.2% were men and 38.8% were
women. We found that 97% of patients with obstructive CAD had at least 1 conventional
cardiovascular risk factor. The adjusted odds ratios (ORs) for obstructive CAD in
women with diabetes (OR, 1.51), hypertension (OR, 1.38), and smoking (OR, 1.39) were
statistically significantly greater than in men (OR, 1.20 for diabetes; OR, 1.08 for
hypertension; OR, 1.14 for smoking; P < 0.001). The sex difference was even greater for patients with multiple risk factors.
For example, the association with obstructive CAD in women with 4 cardiac risk factors
(OR, 4.30; 95% confidence interval, 3.49-5.28) was almost doubled compared with men
(OR, 2.26; 95%confidence interval, 1.99-2.57; P < 0.001).
Conclusions
Almost all patients with stable CAD undergoing cardiac catheterization had at least
1 traditional cardiac risk factor. Importantly, the association between multiple cardiac
risk factors and the presence of obstructive CAD is substantially stronger in women
than men.
Résumé
Introduction
Une recherche approfondie a démontré l’importance des facteurs de risque cardiovasculaire
traditionnels dans la prédiction des événements coronariens aigus. Notre principal
objectif était d’évaluer le lien entre les facteurs de risque traditionnels et la
présence de coronaropathie (CP) obstructive, et d’examiner les différences potentielles
entre les hommes et les femmes.
Méthodes
Une étude observationnelle a été menée auprès d’une cohorte en population générale
de patients stables qui avaient subi un cathétérisme cardiaque en Ontario, au Canada.
Nous avons examiné le lien du diabète, de l’hypertension, de l’hyperlipidémie et du
tabagisme lors de CP obstructive chez les hommes et les femmes en utilisant les modèles
de régression logistique multivariée.
Résultats
Parmi les 46 490 patients qui faisaient partie de notre étude, 61,2 % étaient des
hommes et 38,8 % étaient des femmes. Nous avons observé que 97 % des patients souffrant
d’une CP obstructive avaient au moins 1 facteur de risque cardiovasculaire traditionnel.
Le ratio d’incidence approché (RIA) ajusté de la CP obstructive des femmes souffrant
de diabète (RIA, 1,51), d’hypertension (RIA, 1,38) et fumant (RIA, 1,39) étaient significativement
plus grand sur le plan statistique que celui des hommes (RIA, 1,20 pour le diabète;
RIA, 1,08 pour l’hypertension; RIA, 1,14 pour le tabagisme; P < 0,001). La différence entre les sexes était encore plus grande chez les patients
ayant de multiples facteurs de risque. Par exemple, le lien entre la CP obstructive
chez les femmes ayant 4 facteurs de risque cardiaque (RIA, 4,30; intervalle de confiance
à 95 %, 3,49-5,28) doublait presque par rapport aux hommes (RIA, 2,26; intervalle
de confiance à 95 %, 1,99-2,57; P < 0,001).
Conclusions
Presque tous les patients souffrant d’une CP stable et ayant subi un cathétérisme
cardiaque avaient au moins 1 facteur de risque traditionnel. Notamment, le lien entre
les multiples facteurs de risque et la présence de CP obstructive est considérablement
plus important chez les femmes que chez les hommes.
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Article info
Publication history
Published online: May 02, 2014
Accepted:
April 28,
2014
Received:
February 27,
2014
Footnotes
See page 826 for disclosure information.
Identification
Copyright
© 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
