Gender-based differences in coronary artery disease: A prospective observational study from a North Indian state

Introduction: Coronary artery disease (CAD) causes significant morbidity and mortality in both genders, however, the importance of CAD in females is underappreciated. Aims and Objectives: This study is aimed at investigating the gender-based differences in presentation, evaluation, and outcome of CADs in a northern state of India. Materials and Methods: This is a prospective study conducted over a period of 3 years. All the patients with CAD (acute coronary syndrome or chronic stable angina) enrolled in the study were evaluated for clinical profile, angiographic profile, and the outcome. Results: A total of 3660 patients were enrolled in this study. There were 56.2% of males and 43.8% of females. Smoking as risk factor was noted in 69.6% of males and 7.9% of females, hypertension in 52.9% of males versus 65.4% of females, diabetes in 42.5% of males versus 60.7% of females, and obesity in 46.2% of males versus 57.3% of females. Male versus female mean body mass index was 24.7 versus 27.4, low-density lipoprotein 112.8 versus 123.7, high-sensitivity C-reactive protein 1.5 versus 2.9, and Lp(a) 274.9 versus 442.1, respectively. On coronary angiographic evaluation, male versus female single-vessel involvement was seen in 54.1% versus 58.8% of patients, double-vessel disease in 31.6% versus 27.6%, left main disease in 1.7% versus 3.6%, and spontaneous coronary artery dissection in 0.9% versus 1.5% patients, respectively. The overall mortality in males was 4.03% and 5.11% in females. Conclusion: Despite its atypical presentation, CAD has the worst outcome in women than men. Greater awareness of these gender-based differences will significantly improve the management and outcome of CAD in women.