title: Polygamy and Risk of Coronary Artery Disease in Men Undergoing Angiography: An Observational Study.
abstract: Epidemiologic evidence suggests a link between psychosocial risk factors such as marital status and coronary artery disease (CAD). Polygamy (multiple concurrent wives) is a distinct marital status practiced in many countries in Asia and the Middle East, but its association with CAD is not well defined. We conducted a multicenter, observational study of consecutive patients undergoing coronary angiography during the period from April 1, 2013, to March 30, 2014. Of 1,068 enrolled patients, 687 were married men. Polygamy was reported in 32% of married men (1 wife: 68%, 2 wives: 19%, 3 wives: 10%, and 4 wives: 3%). When stratified by number of wives, significant baseline differences were observed in age, type of community (rural versus urban), prior coronary artery bypass grafting (CABG), and household income. After adjusting for baseline differences, there was a significant association between polygamy and CAD (adjusted OR 4.6 [95% CI 2.5, 8.3]), multivessel disease (MVD) (adjusted OR 2.6 [95% CI 1.8, 3.7]), and left main disease (LMD) (adjusted OR 3.5 [95% CI 2.1, 5.9]). Findings were consistent when the number of wives was analyzed as a continuous variable. In conclusion, among married men undergoing coronary angiography for clinical indications, polygamy is associated with the presence of significant CAD, MVD, and LMD.
authors.affiliation: Section of Adult Cardiology, Cardiovascular Department, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia.
authors.forename: Amin
authors.identifier: 0000-0001-7269-1195
authors.initials: A
authors.lastname: Daoulah
authors.affiliation: Division of Cardiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA.
authors.forename: Amir
authors.initials: A
authors.lastname: Lotfi
authors.affiliation: Cardiovascular Department, Armed Forces Hospital, Southern Region, Khamis Mushayt, Saudi Arabia.
authors.forename: Mushabab
authors.initials: M
authors.lastname: Al-Murayeh
authors.affiliation: Cardiovascular Department, Zayed Military Hospital, Abu Dhabi, UAE.
authors.forename: Salem
authors.initials: S
authors.lastname: Al-Kaabi
authors.affiliation: Section of Pulmonology, Internal Medicine Department, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia.
authors.forename: Salem M
authors.initials: SM
authors.lastname: Al-Faifi
authors.affiliation: Cardiac Center, King Abdullah Medical City in Holy Capital, Makkah, Saudi Arabia.
authors.forename: Osama E
authors.identifier: 0000-0001-6301-7553
authors.initials: OE
authors.lastname: Elkhateeb
authors.affiliation: Cardiovascular Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
authors.forename: Mohamed N
authors.initials: MN
authors.lastname: Alama
authors.affiliation: Cardiovascular Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
authors.forename: Ahmad S
authors.initials: AS
authors.lastname: Hersi
authors.affiliation: Emergency Department, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
authors.forename: Ciaran M
authors.initials: CM
authors.lastname: Dixon
authors.affiliation: Section of Infectious Disease, Internal Medicine Department, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia.
authors.forename: Waleed
authors.initials: W
authors.lastname: Ahmed
authors.affiliation: Cardiovascular Department, Armed Forces Hospital, Southern Region, Khamis Mushayt, Saudi Arabia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Al-Shehri
authors.affiliation: Cardiovascular Department, Suez Canal University, Ismailia, Egypt.
authors.forename: Ali
authors.initials: A
authors.lastname: Youssef
authors.affiliation: Cardiovascular Department, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
authors.forename: Ahmed Moustafa
authors.initials: AM
authors.lastname: Elimam
authors.affiliation: Cardiac Center, King Abdullah Medical City in Holy Capital, Makkah, Saudi Arabia.
authors.forename: Ayman S
authors.initials: AS
authors.lastname: Abougalambou
authors.affiliation: Cardiovascular Department, Zayed Military Hospital, Abu Dhabi, UAE.
authors.forename: Waheed
authors.initials: W
authors.lastname: Murad
authors.affiliation: College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE; Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, UAE.
authors.forename: Alawi A
authors.initials: AA
authors.lastname: Alsheikh-Ali