To identify potential differences between concentrations of thrombogenic markers associated to coronary obstruction in men and women.
Patients and Methods:
We included 502 consecutive patients (251 men and 251 women), with a mean age of 63.94(11.26) and 66.08(10.58) years respectively. In all patients coronary arteriography was performed, either by presenting an acute coronary episode or for discard coronary heart disease (CHD). CHD was defined as a ≥50% narrowing of lumen in one of the three major coronary arteries. At the hospital admission, a blood sample was withdrawn to determine lipoprotein (a), fibrinogen, C reactive protein (CRP) and D-dimer levels. Patients also answered a survey questionnaire which included family and personal history of cardiovascular disease, and personal habits. Weight, height, and abdominal perimeter were also measured.
80.47% of men and 59.36% of women presented coronary heart disease. Hypertension, diabetes and dyslipidaemia were clearly associated with CHD in women whereas in men only dyslipidaemia and diabetes showed this association. D-dimer was the only marker with significantly higher values (p<0.032) in men with coronary obstruction, while in women these markers were CRP (p<0.004), Lp(a) (p<0.001) and fibrinogen (p<0.045). In the multivariate analysis, hypertension, dyslipidaemia, smoking habit and Lp(a) showed an independently association with CHD in women, whereas in men dyslipidaemia and age were the independent risk factors for CHD.
Our results strongly suggest that major cardiovascular risk factors associated to CHD present gender differences. Lipoprotein (a) proved to be the only differential thrombogenic factor between men and women independently associated with coronary obstruction.