Gender differences in patients presenting with premature coronary artery disease

A BSTRACT Objectives: To study gender differences according to severity and manifestations in patients presenting with premature coronary artery disease (PCAD). Methods: In this retrospective study, patients’ information, including demographic data, chemical biomarkers, and coronary angiography findings, was obtained from the electronic system at King Khaled University Hospital (KKUH), Riyadh, Saudi Arabia, during the period between 2015 and 2022. Gensini and vessel scores were calculated from patients’ angiographic reports. Results: Among males, 53.5% of the subjects had a Gensini score of > 39; only 39.5% of females had such a Gensini score ( P = 0.021). Electrocardiography (ECG) changes revealed more frequent ST elevation in the anterior leads among females than among males. According to the vessel score, 57.4% of males and 58.2% of females had two- or three-vessel occlusions ( P = 0.150). Approximately 8% of male patients and 3.5% of female patients had left main artery occlusion. The 45–50 years age group was associated with a higher rate of PCAD development, and this effect was more pronounced among females than among males, while in younger age groups, males were higher than females. Conclusions: Male patients had more severe vessel occlusion than female patients according to the Gensini score, while anterior ST elevation is more prominent in females. More than 8% of the male patients had left main artery occlusion compared to 3.5% of the female patients who had main artery occlusions.