Abstract 3080: Sex Differences in Peripheral Arterial Disease
Background: We aimed to determine whether sex differences exist in the distribution of peripheral arterial disease (PAD) in a group of patients referred for coronary angiography.
Methods and Results: Analyses were performed on 1561 (1014 men, 547 women) subjects (mean age ± SD, 65 ± 11 years) referred for elective coronary angiography at Stanford and Mt. Sinai Medical Centers from 2004 to 2008. Significant coronary artery disease (CAD) was defined as ≥ 60% stenosis, and PAD was defined as ankle-brachial index (ABI) < 0.9. When compared to men, women were significantly more likely to be older and African-Americans, had somewhat higher body mass index (BMI), HDL and LDL cholesterol levels, higher systolic and lower diastolic blood pressures and were less likely to smoke. Women had significantly less prevalent and less severe CAD (P <0.001) than men. Surprisingly, despite similar levels of cardiovascular risk and despite less CAD, women had lower mean ABI (P <0.001) and a higher prevalence of PAD (P =0.007) than men. Multiple regression modeling showed in rank order that female sex (P <0.001), black race (P <0.001), older age (P <0.001), tobacco use (P <0.001), CAD (P <0.001), diabetes (P <0.001) and triglyceride level (P =0.002) were independent negative predictors of ABI. After adjusting for traditional risk factors and CAD in a multivariable logistic regression model, women had a 1.78-fold (95% CI 1.25–2.54) higher risk-adjusted odds ratio for diagnosis of PAD.
Conclusions: In this observational study of patients undergoing elective coronary angiography, there is a greater prevalence of PAD in women. The sex difference in PAD is not explained by traditional risk factors or severity of CAD.