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Korean J Intern Med. 2019 Mar 19. doi: 10.3904/kjim.2018.320. [Epub ahead of print]

Gender differences in the presentation of chest pain in obstructive coronary artery disease: results from the Korean Women's Chest Pain Registry.

Author information

1
Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea.
2
Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
3
Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.
4
Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea.
5
Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
6
Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
7
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
8
Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea.
9
Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Seoul, Korea.

Abstract

Background/Aims:

Chest pain in patients with obstructive coronary artery disease (OCAD) is affected by several social factors. The gender-based differences in chest pain among Koreans have yet to be investigated.

Methods:

The study consecutively enrolled 1,549 patients (male/female, 514/1,035; 61 ± 11 years old) with suspected angina. The predictive factors for OCAD based on gender were evaluated.

Results:

Men experienced more squeezing type pain on the left side of chest, while women demonstrated more dull quality pain in the retrosternal and epigastric area. After adjustment for risk factors, pain in the retrosternal area (odds ratio [OR], 1.491; 95% confidence interval [CI], 1.178 to 1.887) and aggravation by exercise (OR, 2.235; 95% CI, 1.745 to 2.861) were positively associated with OCAD. In men, shorter duration (OR, 1.581; 95% CI, 1.086 to 2.303) and dyspnea (OR, 1.610; 95% CI, 1.040 to 2.490) increased the probability for OCAD, while left-sided chest pain suggested a low probability for OCAD (OR, 0.590; 95% CI, 0.388 to 0.897). In women, aggravation by emotional stress (OR, 0.348; 95% CI, 0.162 to 0.746) and dizziness (OR, 0.457; 95% CI, 0.246 to 0.849) decreased the probability for OCAD.

Conclusions:

This is the first study to focus on gender differences in chest pain among Koreans with angina. Symptoms with high probability for OCAD were different between sexes. Our findings suggest that patient's medical history in pretest assessment for OCAD should be individualized considering gender.

KEYWORDS:

Angina pectoris; Chest pain; Coronary artery disease; Sex characteristics

PMID:
30879289
DOI:
10.3904/kjim.2018.320
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