title: Widowhood and severity of coronary artery disease: a multicenter study.
abstract: OBJECTIVE
  The aim of this study was to assess the association of widowhood with the severity and extent of coronary artery disease (CAD), and whether it is modified by sex or socioeconomic status.
  
  
  METHODS
  A total of 1068 patients undergoing coronary angiography at five centers in Saudi Arabia and the United Arab Emirates were included in the study. CAD was defined as more than 70% lumen stenosis in a major epicardial vessel or more than 50% in the left main coronary artery. Multivessel disease was defined as more than one diseased vessel.
  
  
  RESULTS
  Of 1068 patients, 65 (6%) were widowed. Widowed patients were older (65±15 vs. 59±12), more likely to be female (75 vs. 25%), less likely to be smokers (18 vs. 47%), of lower economic and education status, and more likely to have undergone coronary angiography for urgent/emergent indications (75 vs. 61%) (P<0.05 for all). There was a significant association between widowhood and the number of coronary arteries with more than 70% lumen stenosis. Consequently, such a high degree of lumen stenosis in those who were widowed was more likely to require coronary artery bypass graft surgery (38 vs. 16%; P<0.01). After adjusting for baseline differences, widowhood was associated with a significantly higher odds of CAD [adjusted odds ratio (OR) 3.6; 95% confidence interval (CI) 1.2-10.5] and multivessel disease (adjusted OR 4.6; 95% CI 2.2-9.6), but not left main disease (adjusted OR 1.3; 95% CI 0.5-3.1). All associations were consistent in men and women and not modified by age, community setting (urban vs. rural), employment, income, or educational levels (Pinteraction>0.1 for all).
  
  
  CONCLUSIONS
  Widowhood is associated with the severity and extent of CAD. The association is not modified by sex or socioeconomic status.
authors.affiliation: aCardiovascular Department bInternal Medicine Department, Section of Pulmonology cInternal Medicine Department, King Faisal Specialist Hospital and Research Center dCardiology Unit, King Abdul Aziz University Hospital, Jeddah eCardiac Center, King Abdullah Medical City, Makkah fCardiovascular Department, Armed Forces Hospital Southern Region, Khamis Mushayt, Kingdom of Saudi Arabia gCardiology Department, Zayed Military Hospital hDivision of Adult Cardiology, College of Medicine, Institute of Cardiac Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences iDivision of Adult Cardiology, College of Medicine, Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, UAE jAnesthesia Department kEmergency Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia lDepartment of Cardiology, Division of Cardiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, Massachusetts, USA.
authors.forename: Amin
authors.initials: A
authors.lastname: Daoulah
authors.forename: Mohamed N
authors.initials: MN
authors.lastname: Alama
authors.forename: Osama E
authors.initials: OE
authors.lastname: Elkhateeb
authors.forename: Mushabab
authors.initials: M
authors.lastname: Al-Murayeh
authors.forename: Salem
authors.initials: S
authors.lastname: Al-Kaabi
authors.forename: Salem M
authors.initials: SM
authors.lastname: Al-Faifi
authors.forename: Hind M
authors.initials: HM
authors.lastname: Alosaimi
authors.forename: Amir
authors.initials: A
authors.lastname: Lotfi
authors.forename: Khalid S
authors.initials: KS
authors.lastname: Asiri
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Elimam
authors.forename: Ayman S
authors.initials: AS
authors.lastname: Abougalambo
authors.forename: Waheed
authors.initials: W
authors.lastname: Murad
authors.forename: Mamdouh M
authors.initials: MM
authors.lastname: Haddara
authors.forename: Ciaran M
authors.initials: CM
authors.lastname: Dixon
authors.forename: Alawi A
authors.initials: AA
authors.lastname: Alsheikh-Ali
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012720:Severity of Illness Index; D012737:Sex Factors; D012959:Socioeconomic Factors; D014479:United Arab Emirates / Q000453:epidemiology; D017805:Widowhood / Q000523:psychology*