Gender features of comorbidity in patients with coronary artery disease

• Main Authors: A.N. Sumin, E.V. Korok, A.V. Shcheglova, O.L. Barbarash
• Format: Article
• Language: Russian
• Published: "Consilium Medicum" Publishing house 2018-04-01
• Series: Терапевтический архив
• Subjects: gender differences; comorbidity; coronary heart disease
• Online Access: http://ter-arkhiv.ru/en/archive/2018/vol-90-4-2018/gendernye-osobennosti-komorbidnosti-u-patsientov-s-ishemicheskoy-boleznyu-serdtsa_1455/?element

Aim. To study the factors associated with high levels of comorbidity in men and women with coronary artery disease (CAD). Materials and methods. The data analyzed 742 patients who were screened in the clinic of the research Institute CPSS in 2011, before planned operation coronary artery bypass grafting. All patients were divided into 2 groups: group I – men (n=595; 58 [54; 64] years), group II – women (n=147; 63 [57; 69] years). Results and discussion. The analysis showed that the presence of arterial hypertension and atrial fibrillation prevailed in the group of women (p<0.05), and postinfarction cardiosclerosis (PIC) in the group of men (p=0.004). Men mainly observed lighter I and II functional classes (FC) of angina (p=0.057 and p=0.007) and I stage of chronic heart failure (CHS; p<0.001), women, on the contrary, III and IV FC angina (p=0.005 and p=0.050) and stage III CHS (p<0.001). Atherosclerotic lesions of the arteries of the lower extremities (ALE) were significantly more common in men (p=0.022). Diabetes mellitus (DM), thyroid disease, varicose disease and bronchial asthma (BA) prevailed in the group of women (p<0.05), and chronic hepatitis (p=0.079) and urolithiasis in the group of men (p=0.028). Calculation of the level of comorbidity did not show significant intergroup differences (p>0.05). Although the average level of comorbid pathology prevailed in the whole population – 66% among women and 70.4% among men. Independent predictors that increase the level of comorbidity in male group were: the presence of underground experience, PIC in anamnesis, diabetes, chronic lung disease, stenosis of the ALE for more than 50% increase in the level of glucose in the group of women – the presence of the clinic of angina pectoris IV FC, PIC and movements in the history of the ALE stenosis more than 50%, diabetes, peptic ulcer disease, chronic lung disease, ASTHMA, improving glucose levels (p<0.05). Conclusion. According to the analysis, a high level of comorbidity was found in 13.6% of women and 11.6% of men. Factors associated with high levels of comorbidity, both in men and women were: the presence of diabetes, chronic lung disease, PIC, atherosclerosis of the ALE. At the same time only in women the high level of comorbidity was associated with angina IV FC, peptic ulcer disease, BA, and only in men – with the presence of underground experience. Detection of comorbid pathology in patients with IHD taking into account gender features is advisable for the implementation of patient-oriented approaches in daily clinical work.