Daoulah Amin, Alama Mohamed N, Elkhateeb Osama E, Al-Murayeh Mushabab, Al-Kaabi Salem, Al-Faifi Salem M, Alosaimi Hind M, Lotfi Amir, Asiri Khalid S, Elimam Ahmed M, Abougalambo Ayman S, Murad Waheed, Haddara Mamdouh M, Dixon Ciaran M, Alsheikh-Ali Alawi A
aCardiovascular Department bInternal Medicine Department, Section of Pulmonology cInternal Medicine Department, King Faisal Specialist Hospital and Research Center dCardiology Unit, King Abdul Aziz University Hospital, Jeddah eCardiac Center, King Abdullah Medical City, Makkah fCardiovascular Department, Armed Forces Hospital Southern Region, Khamis Mushayt, Kingdom of Saudi Arabia gCardiology Department, Zayed Military Hospital hDivision of Adult Cardiology, College of Medicine, Institute of Cardiac Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences iDivision of Adult Cardiology, College of Medicine, Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, UAE jAnesthesia Department kEmergency Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia lDepartment of Cardiology, Division of Cardiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts, USA.
Coron Artery Dis. 2017 Mar;28(2):98-103. doi: 10.1097/MCA.0000000000000436.
The aim of this study was to assess the association of widowhood with the severity and extent of coronary artery disease (CAD), and whether it is modified by sex or socioeconomic status.
A total of 1068 patients undergoing coronary angiography at five centers in Saudi Arabia and the United Arab Emirates were included in the study. CAD was defined as more than 70% lumen stenosis in a major epicardial vessel or more than 50% in the left main coronary artery. Multivessel disease was defined as more than one diseased vessel.
Of 1068 patients, 65 (6%) were widowed. Widowed patients were older (65±15 vs. 59±12), more likely to be female (75 vs. 25%), less likely to be smokers (18 vs. 47%), of lower economic and education status, and more likely to have undergone coronary angiography for urgent/emergent indications (75 vs. 61%) (P<0.05 for all). There was a significant association between widowhood and the number of coronary arteries with more than 70% lumen stenosis. Consequently, such a high degree of lumen stenosis in those who were widowed was more likely to require coronary artery bypass graft surgery (38 vs. 16%; P<0.01). After adjusting for baseline differences, widowhood was associated with a significantly higher odds of CAD [adjusted odds ratio (OR) 3.6; 95% confidence interval (CI) 1.2-10.5] and multivessel disease (adjusted OR 4.6; 95% CI 2.2-9.6), but not left main disease (adjusted OR 1.3; 95% CI 0.5-3.1). All associations were consistent in men and women and not modified by age, community setting (urban vs. rural), employment, income, or educational levels (Pinteraction>0.1 for all).
Widowhood is associated with the severity and extent of CAD. The association is not modified by sex or socioeconomic status.
本研究旨在评估丧偶与冠状动脉疾病（CAD）的严重程度和范围之间的关联，以及这种关联是否因性别或社会经济地位而有所改变。
共有1068例在沙特阿拉伯和阿拉伯联合酋长国五个中心接受冠状动脉造影的患者纳入本研究。CAD定义为主要心外膜血管管腔狭窄超过70%或左主干冠状动脉管腔狭窄超过50%。多支血管病变定义为一支以上血管病变。
1068例患者中，65例（6%）丧偶。丧偶患者年龄较大（65±15岁对59±12岁），女性比例更高（75%对25%），吸烟可能性更小（18%对47%），经济和教育水平较低，因紧急/急诊指征接受冠状动脉造影的可能性更大（75%对61%）（所有P<0.05）。丧偶与管腔狭窄超过70%的冠状动脉数量之间存在显著关联。因此，丧偶者如此高度的管腔狭窄更有可能需要冠状动脉搭桥手术（38%对16%；P<0.01）。在调整基线差异后，丧偶与CAD的显著较高几率相关[调整后的优势比（OR）3.6；95%置信区间（CI）1.2 - 10.5]和多支血管病变（调整后的OR 4.6；95% CI 2.2 - 9.6），但与左主干病变无关（调整后的OR 1.3；95% CI 0.5 - 3.1）。所有关联在男性和女性中均一致，且不受年龄、社区环境（城市与农村）、就业、收入或教育水平的影响（所有P交互>0.1）。
丧偶与CAD的严重程度和范围相关。这种关联不受性别或社会经济地位的影响。
