title: Traditional cardiovascular risk factors and the presence of obstructive coronary artery disease in men and women.
abstract: BACKGROUND
  Extensive research has demonstrated the importance of traditional cardiovascular risk factors in predicting acute coronary events. Our main objective was to evaluate the relationship between traditional risk factors and the presence of obstructive coronary artery disease (CAD), and to explore potential differences in men vs women.
  
  
  METHODS
  An observational study was conducted in a population-based cohort of stable patients who underwent cardiac catheterization in Ontario, Canada. We examined the relationship of diabetes, hypertension, hyperlipidemia, and smoking with the presence of obstructive CAD in men and women using multivariable logistic regression models.
  
  
  RESULTS
  Of the 46,490 patients who were included in our study, 61.2% were men and 38.8% were women. We found that 97% of patients with obstructive CAD had at least 1 conventional cardiovascular risk factor. The adjusted odds ratios (ORs) for obstructive CAD in women with diabetes (OR, 1.51), hypertension (OR, 1.38), and smoking (OR, 1.39) were statistically significantly greater than in men (OR, 1.20 for diabetes; OR, 1.08 for hypertension; OR, 1.14 for smoking; P < 0.001). The sex difference was even greater for patients with multiple risk factors. For example, the association with obstructive CAD in women with 4 cardiac risk factors (OR, 4.30; 95% confidence interval, 3.49-5.28) was almost doubled compared with men (OR, 2.26; 95%confidence interval, 1.99-2.57; P < 0.001).
  
  
  CONCLUSIONS
  Almost all patients with stable CAD undergoing cardiac catheterization had at least 1 traditional cardiac risk factor. Importantly, the association between multiple cardiac risk factors and the presence of obstructive CAD is substantially stronger in women than men.
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: dennis.ko@ices.on.ca.
authors: Dennis T
authors: DT
authors: Ko
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors: Harindra C
authors: HC
authors: Wijeysundera
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Women's College Research Institute and Cardiovascular Division, Department of Medicine, Women's College Hospital, Toronto, Ontario, Canada.
authors: Jacob A
authors: JA
authors: Udell
authors: Emory University Rollins School of Public Health and School of Medicine, Atlanta, Georgia, USA.
authors: Viola
authors: V
authors: Vaccarino
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors: Peter C
authors: PC
authors: Austin
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors: Helen
authors: H
authors: Guo
authors: Division of Cardiology, Hamilton Health Sciences Center and McMaster University, Hamilton, Ontario, Canada.
authors: James L
authors: JL
authors: Velianou
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
authors: Kelly
authors: K
authors: Lau
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors: Jack V
authors: JV
authors: Tu
mesh_terms: D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002318:Cardiovascular Diseases / Q000453:epidemiology; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult