The Impact of Gender on Vessel Size in Patients with Angiographically Normal Coronary Arteries

INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.