Divorce and Severity of Coronary Artery Disease: A Multicenter Study.
Amin Daoulah, Mushabab Al-Murayeh, Salem Al-Kaabi, Amir Lotfi, Osama E Elkhateeb, Salem M Al-Faifi, Saleh Alqahtani, James Stewart, Jon Heavey, William T Hurley, Mohamed N Alama, Mazen Faden, Mohamed Al-Shehri, Ali Youssef, Alawi A Alsheikh-Ali
Author Information
Amin Daoulah: Section of Adult Cardiology, Cardiovascular Department, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia. ORCID
Salem Al-Kaabi: Cardiology Department, Zayed Military Hospital, Abu Dhabi, UAE.
Amir Lotfi: Division of Cardiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA.
Osama E Elkhateeb: Cardiac Center, King Abdullah Medical City, Holy Capital, Makkah, Saudi Arabia. ORCID
Salem M Al-Faifi: Section of Pulmonology, Internal Medicine Department, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia.
Saleh Alqahtani: Division of Gastroenterology and Hepatology, The Johns Hopkins Hospital, 1830 East Monument Street, Suite 428, Baltimore, MD 21287, USA.
James Stewart: Anesthesiology Department, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
Jon Heavey: Emergency Medicine Department, Cleveland Clinic Foundation, Cleveland, OH, USA.
William T Hurley: Emergency Medicine Department, Cleveland Clinic Foundation, Cleveland, OH, USA.
Mohamed N Alama: Cardiology Unit, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia.
Mazen Faden: Anesthesiology Department, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia.
The association between marital status and coronary artery disease (CAD) is supported by numerous epidemiological studies. While divorce may have an adverse effect on cardiac outcomes, the relationship between divorce and severe CAD is unclear. We conducted a multicenter, observational study of consecutive patients undergoing coronary angiography during the period between April 1, 2013, and March 30, 2014. Of 1,068 patients, 124 (12%) were divorced. Divorce was more frequent among women (27%) compared to men (6%). Most divorced patients had been divorced only once (49%), but a subset had been divorced 2 (38%) or ≥3 (12%) times. After adjusting for baseline differences, there was no significant association between divorce and severe CAD in men. In women, there was a significant adjusted association between divorce and severe MVD (OR 2.31 [1.16, 4.59]) or LMD (OR 5.91 [2.19, 15.99]). The modification of the association between divorce and severe CAD by gender was statistically significant for severe LMD ( 0.0008) and marginally significant for CAD ( 0.05). Among women, there was a significant adjusted association between number of divorces and severe CAD (OR 2.4 [95% CI 1.2, 4.5]), MVD (OR 2.0 [95% CI 1.4, 3.0]), and LMD (OR 3.4 [95% CI 1.9, 5.9]). In conclusion, divorce, particularly multiple divorces, is associated with severe CAD, MVD, and LMD in women but not in men.
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