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
  1. Amin Daoulah: Section of Adult Cardiology, Cardiovascular Department, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia. ORCID
  2. Mushabab Al-Murayeh: Cardiovascular Department, Armed Forces Hospital Southern Region, Khamis Mushayt, Saudi Arabia.
  3. Salem Al-Kaabi: Cardiology Department, Zayed Military Hospital, Abu Dhabi, UAE.
  4. Amir Lotfi: Division of Cardiology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA.
  5. Osama E Elkhateeb: Cardiac Center, King Abdullah Medical City, Holy Capital, Makkah, Saudi Arabia. ORCID
  6. Salem M Al-Faifi: Section of Pulmonology, Internal Medicine Department, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia.
  7. Saleh Alqahtani: Division of Gastroenterology and Hepatology, The Johns Hopkins Hospital, 1830 East Monument Street, Suite 428, Baltimore, MD 21287, USA.
  8. James Stewart: Anesthesiology Department, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
  9. Jon Heavey: Emergency Medicine Department, Cleveland Clinic Foundation, Cleveland, OH, USA.
  10. William T Hurley: Emergency Medicine Department, Cleveland Clinic Foundation, Cleveland, OH, USA.
  11. Mohamed N Alama: Cardiology Unit, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia.
  12. Mazen Faden: Anesthesiology Department, King Abdul Aziz University Hospital, Jeddah, Saudi Arabia.
  13. Mohamed Al-Shehri: Cardiovascular Department, Armed Forces Hospital Southern Region, Khamis Mushayt, Saudi Arabia.
  14. Ali Youssef: Suez Canal University, Ismailia, Egypt.
  15. Alawi A Alsheikh-Ali: College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE.

Abstract

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.

References

  1. Lancet. 2014 Jan 25;383(9914):309-20 [PMID: 24452042]
  2. J Epidemiol Community Health. 1981 Sep;35(3):192-6 [PMID: 7328378]
  3. Eur J Cardiovasc Nurs. 2014 Oct;13(5):399-407 [PMID: 24104612]
  4. Psychosom Med. 2009 Jun;71(5):532-40 [PMID: 19414618]
  5. Physiol Behav. 2013 Apr 10;114-115:32-7 [PMID: 23500173]
  6. Am J Epidemiol. 1989 Feb;129(2):233-48 [PMID: 2643301]
  7. Fam Process. 1997 Sep;36(3):225-45 [PMID: 9439936]
  8. Natl Vital Stat Rep. 2015 Aug 31;64(10):1-93 [PMID: 26759854]
  9. J Occup Health Psychol. 2014 Apr;19(2):155-67 [PMID: 24730425]
  10. J Epidemiol Community Health. 1982 Dec;36(4):269-73 [PMID: 7166682]
  11. Prev Med. 1986 Nov;15(6):591-605 [PMID: 3797391]
  12. Open Cardiovasc Med J. 2017 Apr 28;11:47-57 [PMID: 28553410]
  13. Fam Process. 2000 Summer;39(2):237-55 [PMID: 10907149]
  14. J Epidemiol Community Health. 2012 Nov;66(11):1056-62 [PMID: 22389515]
  15. J Womens Health (Larchmt). 2007 Nov;16(9):1305-16 [PMID: 18001187]
  16. J Clin Epidemiol. 2004 Oct;57(10):1096-103 [PMID: 15528061]
  17. Eur J Cardiovasc Prev Rehabil. 2008 Oct;15(5):557-61 [PMID: 18800004]
  18. Eur Heart J Cardiovasc Imaging. 2016 Oct;17(10):1128-37 [PMID: 26508517]
  19. Fam Process. 2003 Summer;42(2):269-90 [PMID: 12879598]
  20. J Health Soc Behav. 2009 Sep;50(3):344-58 [PMID: 19711810]
  21. Sports Med. 2014 Jan;44(1):81-121 [PMID: 24030837]
  22. Br Med J (Clin Res Ed). 1985 Nov 30;291(6508):1529-33 [PMID: 3933737]
  23. Heart Lung. 2012 Mar-Apr;41(2):107-14 [PMID: 22054720]
  24. Am J Epidemiol. 2009 Sep 1;170(5):546-55 [PMID: 19584130]
  25. Am J Hypertens. 2007 Feb;20(2):148-53 [PMID: 17261459]
  26. Int J Vasc Med. 2017;2017:1925176 [PMID: 28250991]
  27. Circ Cardiovasc Qual Outcomes. 2015 May;8(3):244-51 [PMID: 25872508]
  28. Eur Eat Disord Rev. 2014 Jan;22(1):77-82 [PMID: 24123563]
  29. J Epidemiol Community Health. 2013 Jan;67(1):71-5 [PMID: 22577182]
  30. JAMA. 2000 Dec 20;284(23):3008-14 [PMID: 11122587]
  31. Health Care Women Int. 1992 Oct-Dec;13(4):393-9 [PMID: 1478900]
  32. J Clin Nurs. 2015 Sep;24(17-18):2468-77 [PMID: 25850608]
  33. Lancet. 2004 Sep 11-17;364(9438):937-52 [PMID: 15364185]
  34. Nat Rev Cardiol. 2012 Apr 03;9(6):360-70 [PMID: 22473079]
  35. Soc Sci Med. 2009 Jul;69(2):223-8 [PMID: 19501442]
  36. Rev Esp Cardiol (Engl Ed). 2016 Mar;69(3):279-85 [PMID: 26654848]
  37. J Health Soc Behav. 2000 Dec;41(4):451-64 [PMID: 11198568]

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