Polygamy and Risk of Coronary Artery Disease in Men Undergoing Angiography: An Observational Study

Introduction:Coronary artery disease (CAD) is a leading cause of death worldwide. The association of socioeconomic status with CAD is supported by numerous epidemiological studies. Whether such factors also impact the number of diseased coronary vessels and its severity is not well established.Materials and Methods: We conducted a prospective multicentre, multi-ethnic, cross sectional observational study of consecutive patients undergoing coronary angiography (CAG) at 5 hospitals in the Kingdom of Saudi Arabia and the United Arab Emirates. Baseline demographics, socioeconomic, and clinical variables were collected for all patients. Significant CAD was defined as ≥70% luminal stenosis in a major epicardial vessel. Left main disease (LMD) was defined as ≥50% stenosis in the left main coronary artery. Multi-vessel disease (MVD) was defined as having >1 significant CAD.Results: Of 1,068 patients (age 59 ± 13, female 28%, diabetes 56%, hypertension 60%, history of CAD 43%), 792 (74%) were from urban and remainder (26%) from rural communities. Patients from rural centres were older (61 ± 12 vs 58 ± 13), and more likely to have a history of diabetes (63 vs 54%), hypertension (74 vs 55%), dyslipidaemia (78 vs 59%), CAD (50 vs 41%) and percutaneous coronary intervention (PCI) (27 vs 21%). The two groups differed significantly in terms of income level, employment status and indication for angiography. After adjusting for baseline differences, patients living in a rural area were more likely to have significant CAD (adjusted OR 2.40 [1.47, 3.97]), MVD (adjusted OR 1.76 [1.18, 2.63]) and LMD (adjusted OR 1.71 [1.04, 2.82]). Higher income was also associated with a higher risk for significant CAD (adjusted OR 6.97 [2.30, 21.09]) and MVD (adjusted OR 2.49 [1.11, 5.56]), while unemployment was associated with a higher risk of significant CAD (adjusted OR 2.21, [1.27, 3.85]).Conclusion:Communal and socioeconomic factors are associated with higher odds of significant CAD and MVD in the group of patients referred for CAG. The underpinnings of these associations (e.g. pathophysiologic factors, access to care, and system-wide determinants of quality) require further study.

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“…A detailed description can be found in Polygamy and Risk of Coronary Artery Disease in Men Undergoing Angiography [39]. …”

Section: Resultsmentioning

confidence: 99%

Socioeconomic Factors and Severity of Coronary Artery Disease in Patients Undergoing Coronary Angiography: A Multicentre Study of Arabian Gulf States

Daoulah

Elkhateeb

Nasseri

et al. 2017

TOCMJ

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“…Overall characteristics of patients and coronary angiogram findings are shown in Table 1 . A detailed description can be found in [ 15 ].…”

Section: Resultsmentioning

confidence: 99%

“…The details regarding the design, methods, and endpoints of this multicenter, cross-sectional observational study came from the Polygamy and Risk of Coronary Artery Disease in Men Undergoing Angiography [ 15 ]. This study was undertaken to assess the relationship between divorce and severe CAD.…”

Section: Methodsmentioning

confidence: 99%

Divorce and Severity of Coronary Artery Disease: A Multicenter Study

Daoulah

Al-Murayeh

Alkaabi

et al. 2017

Cardiology Research and Practice

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The association between marital status and coronary artery disease (CAD) is supported by numerous epidemiological studies. While divorce may have an adverse effect on cardiac outcomes, the relationship between divorce and severe CAD is unclear. We conducted a multicenter, observational study of consecutive patients undergoing coronary angiography during the period between April 1, 2013, and March 30, 2014. Of 1,068 patients, 124 (12%) were divorced. Divorce was more frequent among women (27%) compared to men (6%). Most divorced patients had been divorced only once (49%), but a subset had been divorced 2 (38%) or ≥3 (12%) times. After adjusting for baseline differences, there was no significant association between divorce and severe CAD in men. In women, there was a significant adjusted association between divorce and severe MVD (OR 2.31 [1.16, 4.59]) or LMD (OR 5.91 [2.19, 15.99]). The modification of the association between divorce and severe CAD by gender was statistically significant for severe LMD (Pinteraction 0.0008) and marginally significant for CAD (Pinteraction 0.05). Among women, there was a significant adjusted association between number of divorces and severe CAD (OR 2.4 [95% CI 1.2, 4.5]), MVD (OR 2.0 [95% CI 1.4, 3.0]), and LMD (OR 3.4 [95% CI 1.9, 5.9]). In conclusion, divorce, particularly multiple divorces, is associated with severe CAD, MVD, and LMD in women but not in men.

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“…A detailed description can be found in Polygamy and Risk of Coronary Artery Disease in Men Undergoing Angiography[ 36 ].…”

Section: Resultsmentioning

confidence: 99%

“…The details regarding the design, methods, and endpoints of this multicenter, observational study came from the Polygamy and Risk of Coronary Artery Disease in Men Undergoing Angiography[ 36 ]. In the current study the data were collected prospectively from five hospitals in two Gulf Regions (the Kingdom of Saudi Arabia and the United Arab Emirates), during the period of April 1 st , 2013 to March 30 th , 2014.…”

Section: Methodsmentioning

confidence: 99%

Inter-ethnic marriages and severity of coronary artery disease: A multicenter study of Arabian Gulf States

Daoulah

Alkaabi

Lotfi

et al. 2017

WJC

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AIMTo assess the association of inter-ethnic vs intra-ethnic marriage with severity of coronary artery disease (CAD) in men undergoing angiography.METHODSWe conducted a prospective multicenter, multi-ethnic, cross sectional observational study at five hospitals in Saudi Arabia and the United Arab Emirates, in which we used logistic regression analysis with and without adjustment for baseline differences.RESULTSData were collected for 1068 enrolled patients undergoing coronary angiography for clinical indications during the period of April 1st, 2013 to March 30th, 2014. Ethnicities of spouses were available only for male patients. Of those enrolled, 687 were married men and constituted the cohort for the present analysis. Intra-ethnic marriages were reported in 70% and inter-ethnic marriages in 30%. After adjusting for baseline differences, inter-ethnic marriage was associated with lower odds of having significant CAD [adjusted odds ratio 0.52 (95%CI: 0.33, 0.81)] or multi-vessel disease (MVD) [adjusted odds ratio 0.57 (95%CI: 0.37, 0.86)]. The adjusted association with left main disease showed a similar trend, but was not statistically significant [adjusted odds ratio 0.74 (95%CI: 0.41, 1.32)]. The association between inter-ethnic marriage and the presence of significant CAD and MVD was not modified by number of concurrent wives (P interaction > 0.05 for both).CONCLUSIONAmong married men undergoing coronary angiography, inter-ethnic, as compared to intra-ethnic, marriage is associated with lower odds of significant CAD and MVD.

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Polygamy and Risk of Coronary Artery Disease in Men Undergoing Angiography: An Observational Study

Cited by 4 publications

References 26 publications

Socioeconomic Factors and Severity of Coronary Artery Disease in Patients Undergoing Coronary Angiography: A Multicentre Study of Arabian Gulf States

Socioeconomic Factors and Severity of Coronary Artery Disease in Patients Undergoing Coronary Angiography: A Multicentre Study of Arabian Gulf States

Divorce and Severity of Coronary Artery Disease: A Multicenter Study

Inter-ethnic marriages and severity of coronary artery disease: A multicenter study of Arabian Gulf States

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