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

Korean Journal of Internal Medicine 2020년 35권 3호 p.582 ~ 592
Cho Dong-Hyuk, 최지미, 김학령, 김용현, 나진오, 정진옥, 윤현주, 신미승, 김명아, 홍경순, 신길자, 박성미, 심완주,
소속 상세정보
 ( Cho Dong-Hyuk ) - Korea University Anam Hospital Department of Internal Medicine
최지미 ( Choi Ji-Mi ) - Korea University Anam Hospital Department of Internal Medicine
김학령 ( Kim Hack-Lyoung ) - Seoul Metropolitan Government Seoul National University Boramae Medical Center Department of Internal Medicine
김용현 ( Kim Yong-Hyun ) - Korea University Ansan Hospital Department of Internal Medicine
나진오 ( Na Jin-Oh ) - Korea University Guro Hospital Department of Internal Medicine
정진옥 ( Jeong Jin-Ok ) - Chungnam National University Hospital Department of Internal Medicine
윤현주 ( Yoon Hyun-Ju ) - Chonnam National University Hospital Department of Internal Medicine
신미승 ( Shin Mi-Seung ) - Gachon University Gil Medical Center Department of Internal Medicine
김명아 ( Kim Myung-A ) - Seoul Metropolitan Government Seoul National University Boramae Medical Center Department of Internal Medicine
홍경순 ( Hong Kyung-Soon ) - Hallym University Chuncheon Sacred Heart Hospital Department of Internal Medicine
신길자 ( Shin Gil-Ja ) - Ewha Womans University Mokdong Hospital Department of Internal Medicine
박성미 ( Park Seong-Mi ) - Korea University Anam Hospital Department of Internal Medicine
심완주 ( Shim Wan-Joo ) - Korea University Anam Hospital Department of Internal Medicine

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.

키워드

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

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