Sumin A N, Korok E V, Gaĭfulin R A, Bezdenezhnykh A V, Barbarash O L
Klin Med (Mosk). 2014;92(1):34-40.
Multifocal atherosclerosis (MFA) has negative effect on prognosis in various groups of patients with cardiovascular diseases. However, gender-specific features of MFA are practically unexplored which provided a rationale for the present work.
To study gender-specific features of MFA in patients with atherosclerosis of different localization.
1018 patients examined and treated prior to planned surgical intervention on coronary arteries, carotid basin, aorta, and arteries of lower extremities. Group 1 included 193 women aged 59 = 69 (mean 63) years, group 2 was comprised of 825 men aged 53-63 (mean 57 years). All the patients underwent coronarography (CG). Analysis of MFA prevalence was made.
The women were older than the men, they were more frequently overweight, suffered arterial hypertension and diabetes mellitus (p < 0.001), showed the higher left ventricular ejection fraction (p = 0.011). Smokers more frequently occurred among men (p < 0.001). CG revealed more lesions in a single vessel (p = 0.023) and less t lesions affecting three vessels (p = 0.015) in men. Signs of MFA were recorded in 28.0% of the men and 24.4% of the women (p = 0.306). Combined lesions of the coronary and carotid basins were more frequent in women (p = 0.048). Clinically significant stenosis of the coronary bed, aortoiliac segment or lower limb arteries occurred more frequently in men (p = 0.012). All three basins were more frequently affected in men (p = 0.061).
MFA before planned cardiovascular surgery was diagnosed in 27.3% of the cases. Combined lesions in coronary and carotid arteries more frequently occurred in women and those in coronary and lower limb arteries in men (p < 0.05). Most risk factors (except smoking) are more frequently inherent in women in association with the enhanced frequency of three-vessel lesions affecting coronary arteries.