Yang Felix, Minutello Robert M, Bhagan Sherrita, Sharma Atul, Wong S Chiu
Department of Medicine, Weill Cornell Medical College, New York, New York 10021, USA.
J Interv Cardiol. 2006 Aug;19(4):340-4. doi: 10.1111/j.1540-8183.2006.00157.x.
Female gender has been associated with worse clinical outcomes following coronary revascularization. Whether a gender-specific difference in vessel size is contributing to this finding remains controversial. We sought to better define the relationship between gender and coronary artery size.
Baseline characteristics were obtained and quantitative coronary angiography was performed on 145 consecutive patients with angiographically normal (smooth luminal surface with no evidence of any irregularity in the coronary tree) coronary arteries. Two separate orthogonal measurements each were taken of the left main, proximal left anterior descending, proximal circumflex, proximal right coronary artery, and ostial posterior descending arteries. An average coronary size, derived from five separate coronary artery measurements, was tabulated for each patient.
After correcting for confounding variables, including BSA, height, diabetes, and left ventricular hypertrophy using multivariate linear regression, female gender remained a strong independent predictor of coronary vessel size (Beta =-0.30, P = 0.004). Female gender was associated with a 0.30 mm decrease in average coronary size.
Gender is a strong, independent predictor of coronary artery size even when taking into account differences in body size. This difference may contribute to worse outcomes of women undergoing coronary revascularization.
女性在冠状动脉血运重建术后的临床结局较差。血管大小的性别特异性差异是否导致了这一结果仍存在争议。我们试图更好地界定性别与冠状动脉大小之间的关系。
获取了145例冠状动脉造影显示正常（管腔表面光滑，冠状动脉树无任何不规则迹象）的连续患者的基线特征，并进行了定量冠状动脉造影。对左主干、左前降支近端、回旋支近端、右冠状动脉近端和后降支开口处分别进行两次独立的正交测量。为每位患者列出从五个独立冠状动脉测量值得出的平均冠状动脉大小。
使用多变量线性回归校正包括体表面积、身高、糖尿病和左心室肥厚等混杂变量后，女性仍然是冠状动脉大小的强有力独立预测因素（β=-0.30，P=0.004）。女性与平均冠状动脉大小减少0.30毫米相关。
即使考虑到体型差异，性别仍是冠状动脉大小的强有力独立预测因素。这种差异可能导致接受冠状动脉血运重建术的女性预后较差。
