Key result
Later age at menarche is linked to ~27% higher obstructive CAD risk.
Why the study?
Whether reproductive factors are associated with coronary artery disease has been debated and requires investigation.
Are reproductive factors associated with angiographic obstructive CAD in women with chest pain?
Observational (n=687)
Yes
Are reproductive factors associated with angiographic obstructive CAD in women with chest pain?
Odds Ratio: 1.265 (95% CI 1.064–1.504)
p-value: p=0.008
Later age at menarche and an increased number of pregnancies are independent predictors of angiographic obstructive CAD in women with chest pain, highlighting the role of hormonal status in CAD development.
Later menarche and more pregnancies were associated with obstructive CAD; leaves open whether reproductive history refines CAD risk assessment in women.
BACKGROUND: Whether reproductive factors are associated with coronary artery disease (CAD) has been debated. The aim of this study was to investigate etiologic associations of a wide range of reproductive factors of women with the presence of angiographic obstructive CAD. MATERIALS AND METHODS: Study data were obtained from a nationwide registry that enrolled 687 Korean women (59.9 ± 11.4 years) with chest pain undergoing invasive coronary angiography (ICA). Obstructive CAD was defined as ≥50% luminal stenosis of one or more epicardial coronary arteries in ICA. Information on reproductive history, including ages at menarche and menopause, duration of reproductive capacity, number of pregnancies, hormonal replacement therapy, and history of twin pregnancy, was obtained using a standardized questionnaire. RESULTS: A total of 178 women (25.9%) had obstructive CAD. Multivariable logistic regression analysis identified that later age at menarche (odds ratio [OR] = 1.265, 95% confidence interval [CI] = 1.064-1.504, p = 0.008, per year) and increased number of pregnancies (OR = 1.223, 95% CI = 1.026-1.457, p = 0.025, per pregnancy) were the independent predictors of obstructive CAD even after controlling for potential confounders, including age, diabetes mellitus, hypertension, dyslipidemia, renal function, high-density lipoprotein level, white blood cell count, hemoglobin, and E/e'. CONCLUSIONS: Later age at menarche and increased number of pregnancies may be reproductive risk factors for angiographic obstructive CAD, suggesting the important role of hormonal status in the development of CAD.
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Kim et al. (2015) conducted an observational in Chest pain with suspected coronary artery disease (n=687). Later age at menarche and increased number of pregnancies was evaluated on Angiographic obstructive CAD (≥50% luminal stenosis of one or more epicardial coronary arteries) (OR 1.265, 95% CI 1.064-1.504, p=0.008). Later age at menarche (OR 1.265; 95% CI 1.064-1.504; p=0.008) and increased number of pregnancies (OR 1.223; 95% CI 1.026-1.457; p=0.025) were independent predictors of angiographic obstructive CAD.
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