Sex Differences in Obstructive Coronary Artery

SUMMARY The symptoms, ECGs, exercise stress responses, left ventricular perfusion and function, and the topography of obstructive coronary artery disease (3 70 % cross-sectional stenosis in the left main, left anterior descending, circumflex, and right coronary arteries and their major branches) were analyzed in 200 patients 65 years of age or older with angina pectoris. Males showed a significantly higher incidence of stenosis of the left main and the left circumflex coronary arteries and poorer left ventricular perfusion than females. One-vessel obstructive disease was found in one-fifth of the aged patients of each sex with angina pectoris. CORONARY ATHEROSCLEROSIS begins earlier and advances more rapidly in men than in women. Sex differences are maximal in the fifth decade, but dimin-ish after the seventh decade.1 ' 2 Because coronary ar-tery surgery is an increasingly common recommenda-tion for geriatric (- 65 years) patients with angina pectoris, the atherosclerotic topography and its conse-quences on ventricular perfusion and function are im