Sex differences of the association between marital status and coronary artery disease in patients experiencing chest pain: The Korean Women's Chest Pain Registry

Abstract

Objective: Marriage is an important social practice that predicts various health outcomes, including those of cardiovascular disease. This study investigated the sex-specific association between marital status and coronary artery disease (CAD) in patients experiencing chest pain. Methods: Study data were obtained from a nationwide registry of patients with suspected CAD who underwent coronary angiography. We dichotomized all participants according to marital status as follows: without a spouse (single, divorced, or widowed), and with a spouse. Significant CAD was defined as greater than 50% narrowing of the lumen diameter in any of the coronary arteries. Results: The presence of significant CAD was significantly higher in female participants without a spouse than in female participants with a spouse. However, there was no significant difference in the presence of CAD in men between the two groups. Interestingly, there was also no significant difference in the presence of CAD between women without a spouse and men without a spouse. After adjustment for all possible confounding factors, women without a spouse had a 1.62-fold increased hazard for significant CAD in multivariate regression analysis. Conclusions: In contrast to men, a without spouse status is independently associated with significant CAD in women experiencing chest pain. Women with a spouse had the lowest presence of CAD among all groups. In the management of female patients experiencing chest pain, clinicians should consider their social characteristics, including marital status, to predict subsequent cardiovascular disease and determine the appropriate treatment.