What is the clinical evidence from this study?

Study design: Observational. Population: Chest pain suspected of coronary artery disease (n=688). Intervention: Diabetes mellitus vs. No diabetes mellitus. Primary outcome: Presence of obstructive coronary artery disease (≥50% luminal narrowing) (OR 2.4, 95% CI 1.8-3.3, p=0.001).

What does this research mean for the field?

Diabetes mellitus significantly increases the odds of obstructive coronary artery disease (OR 2.4) in Palestinian women presenting with chest pain, who also exhibit a high prevalence of clustered traditional cardiovascular risk factors. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 1, 2015World Journal of Cardiovascular Diseases10 citationsOpen Access

Characteristics and Risk Factors Attributed to Coronary Artery Disease in Women Attended Health Services in Gaza-Palestine Observational Study

YAYehia AbedUniversity of Palestine AJAmal JameeAl-Quds University

Key Result

Diabetes mellitus significantly increased the odds of obstructive coronary artery disease (OR 2.4) in Palestinian women presenting with chest pain.

Study Design

Type

Observational (n=688)

Multicenter

Structured PICO

Population

688 women aged 32-96 years (mean age 61) with chest pain who underwent coronary angiography for the first time during 2010-2013 at a cardiology center in Gaza, Palestine. Exclusions: congenital heart disease, valvular heart disease, prior cardiac surgery or percutaneous coronary intervention.

Outcome

Presence of significant coronary artery disease (CAD), defined as ≥50% luminal narrowing in at least one vessel on coronary angiography.surrogate

In Palestinian women undergoing coronary angiography for chest pain, traditional risk factors like age and diabetes are strong independent predictors of obstructive coronary artery disease, while atypical chest pain is highly predictive of normal coronaries.

Main Result

Effect estimate: OR 2.4 (95% CI 1.8-3.3)

Absolute Event Rate: 63.6% vs 42.2%

p-value: p=0.001

Limitations

Retrospective record-based study design may expose results to inaccuracies in data recording.
Exclusion of cigarette smoking as a variable because it is not an accepted practice for women in the society.

Abstract

Coronary artery disease (CAD) is the leading cause of death in both sexes worldwide, and becomes number one killer in women due to many factors including increase in traditional risk factors, delays in apparition of symptoms, under estimation of diagnosis test and treatment. Our study aims to identify risk factors for coronary artery disease among women with chest pain underwent coronary angiography during years (2010-2013) in cardiology center. The study design is an observational among 688 women-aged 32 - 96 years; the mean age of our study population is 61 years. Risk factors are abstracted from patients’ files. Women with documented coronaries disease tend to be older, have higher, systolic blood pressure, serum level of triglyceride, and impaired clearance creatinine. 59.4% of them are menopause with higher prevalence of hypertension and diabetes (58.6% and 63.6%). Significant positive association is found in women with myocardial infarction, unstable angina, stable angina and presence of obstructive coronary artery disease respectively (89.6%, 82.3%, 59.1%) in opposite women presented with atypical chest pain have high prevalence of normal coronaries (95.7%). About 57.6% have more than three risk factors, and 55.3% are obese or overweight. In addition, 42.1% of them have impaired systolic function. We conclude that cardiovascular risk factors are highly prevalent among Palestinians women in Gaza and the combination of risk factors is common. Interventions to minimize CAD in our population are needed.

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