{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:49:08Z","timestamp":1790470148100,"version":"4.1.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T00:00:00Z","timestamp":1641168000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T00:00:00Z","timestamp":1641168000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Biol Sex Differ"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Focused evaluations on potential sex differences in the angiographic findings of the coronary arteries are scarce. This study was performed to compare the angiographic extent and localization of coronary stenosis between men and women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 2348 patients (mean age 62.5 years and 60% women) with stable chest pain undergoing invasive coronary angiography (CAG) were recruited from the database of the nation-wide chest pain registry. Obstructive coronary artery disease (CAD) was defined as\u2009\u2265\u200950% stenosis of the left main coronary artery and\/or\u2009\u2265\u200970% stenosis of any other epicardial coronary arteries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Although women were older than men (64.4\u2009\u00b1\u200910.3 vs. 59.5\u2009\u00b1\u200911.4 years,<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), men had worse risk profiles including high blood pressure, more frequent smoking and elevated triglyceride and C-reactive protein. The prevalence of obstructive CAD was significantly higher in men than in women (37.0% vs. 28.4%,<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Men had a higher prevalence of LM disease (10.3% vs. 3.5%,<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and three-vessel disease (16.1% vs. 9.5%,<jats:italic>P<\/jats:italic>\u2009=\u20090.007) compared to women. In multiple binary logistic regression analysis, the risk of men having LM disease or three-vessel disease was 7.4 (95% confidence interval 3.48\u201315.97;<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and 2.7 (95% confidence interval 1.57\u20134.64;<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) times that of women, respectively, even after controlling for potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In patients with chest pain undergoing invasive CAG, men had higher obstructive CAD prevalence and more high-risk angiographic findings such as LM disease or three-vessel disease.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13293-021-00411-1","type":"journal-article","created":{"date-parts":[[2022,1,3]],"date-time":"2022-01-03T10:04:48Z","timestamp":1641204288000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Sex differences in coronary angiographic findings in patients with stable chest pain: analysis of data from the KoRean wOmen\u2019S chest pain rEgistry (KoROSE)"],"prefix":"10.1186","volume":"13","author":[{"given":"Hack-Lyoung","family":"Kim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun-Jin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Min","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Ju","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Sup","family":"Byun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seong Mi","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mi Seung","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung-Soon","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3064-7118","authenticated-orcid":false,"given":"Myung-A","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,3]]},"reference":[{"key":"411_CR1","first-page":"e139","volume":"141","author":"SS Virani","year":"2020","unstructured":"Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, et al. Heart disease and stroke statistics\u20142020 update: a report from the American Heart Association. Circulation. 2020;141:e139\u2013596.","journal-title":"Circulation"},{"key":"411_CR2","doi-asserted-by":"crossref","unstructured":"GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1736\u201388.","DOI":"10.1016\/S0140-6736(18)32203-7"},{"key":"411_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jacc.2017.04.052","volume":"70","author":"GA Roth","year":"2017","unstructured":"Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyuet G, et al. Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol. 2017;70:1\u201325.","journal-title":"J Am Coll Cardiol"},{"key":"411_CR4","doi-asserted-by":"publisher","first-page":"2145","DOI":"10.1161\/CIRCULATIONAHA.110.968792","volume":"124","author":"L Mosca","year":"2011","unstructured":"Mosca L, Barrett-Connor E, Wenger NK. Sex\/gender differences in cardiovascular disease prevention: what a difference a decade makes. Circulation. 2011;124:2145\u201354.","journal-title":"Circulation"},{"key":"411_CR5","doi-asserted-by":"publisher","first-page":"1657","DOI":"10.1038\/s41591-019-0643-8","volume":"25","author":"E Gerdts","year":"2019","unstructured":"Gerdts E, Regitz-Zagrosek V. Sex differences in cardiometabolic disorders. Nat Med. 2019;25:1657\u201366.","journal-title":"Nat Med"},{"key":"411_CR6","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1016\/j.jacc.2009.04.098","volume":"54","author":"LJ Shaw","year":"2009","unstructured":"Shaw LJ, Bugiardini R, Merz CN. Women and ischemic heart disease: evolving knowledge. J Am Coll Cardiol. 2009;54:1561\u201375.","journal-title":"J Am Coll Cardiol"},{"key":"411_CR7","doi-asserted-by":"publisher","first-page":"1272","DOI":"10.1097\/GME.0000000000001392","volume":"26","author":"JH Cho","year":"2019","unstructured":"Cho JH, Kim HL, Kim MA, Oh S, Kim M, Park SM, et al. Association between obesity type and obstructive coronary artery disease in stable symptomatic postmenopausal women: data from the KoRean wOmen\u2019S chest pain rEgistry (KoROSE). Menopause. 2019;26:1272\u20136.","journal-title":"Menopause"},{"key":"411_CR8","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1111\/jch.12862","volume":"19","author":"HL Kim","year":"2017","unstructured":"Kim HL, Kim MA, Shim WJ, Oh S, Kim M, Park SM, et al. Sex difference in the association between brachial pulse pressure and coronary artery disease: the Korean Women\u2019s Chest Pain Registry (KoROSE). J Clin Hypertens. 2017;19:38\u201344.","journal-title":"J Clin Hypertens"},{"key":"411_CR9","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1089\/jwh.2015.5381","volume":"25","author":"HL Kim","year":"2016","unstructured":"Kim HL, Kim MA, Shim WJ, Park SM, Kim YH, Na JO, et al. Reproductive factors predicting angiographic obstructive coronary artery disease: the KoRean wOmen\u2019S Chest Pain rEgistry (KoROSE). J Women\u2019s Health. 2016;25:443\u20138.","journal-title":"J Women\u2019s Health"},{"key":"411_CR10","doi-asserted-by":"publisher","first-page":"40","DOI":"10.7570\/jomes.2019.28.1.40","volume":"28","author":"MH Seo","year":"2019","unstructured":"Seo MH, Lee WY, Kim SS, Kang JH, Kang JH, Kim KK, et al. 2018 Korean Society for the study of obesity guideline for the management of obesity in Korea. J Obes Metab Syndr. 2019;28:40\u20135.","journal-title":"J Obes Metab Syndr"},{"key":"411_CR11","doi-asserted-by":"publisher","first-page":"2345","DOI":"10.1161\/01.CIR.99.17.2345","volume":"99","author":"PJ Scanlon","year":"1999","unstructured":"Scanlon PJ, Faxon DP, Audet AM, Carabello B, Dehmer GJ, Eagle KA, et al. ACC\/AHA guidelines for coronary angiography: executive summary and recommendations. Circulation. 1999;99:2345\u201357.","journal-title":"Circulation"},{"key":"411_CR12","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1016\/j.jacc.2014.07.017","volume":"64","author":"SD Fihn","year":"2014","unstructured":"Fihn SD, Blankenship JC, Alexander KP, Bittl JA, Byrne JG, Fletcher BJ, et al. 2014 ACC\/AHA\/AATS\/PCNA\/SCAI\/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2014;64:1929\u201349.","journal-title":"J Am Coll Cardiol"},{"key":"411_CR13","doi-asserted-by":"crossref","unstructured":"Cerqueira MD, Weissman NJ, Dilsizian V, Jacobs AK, Kaul S, Laskey WK, et al. Standardized myocardial segmentation and nomenclature for tomographic imaging of the heart. A statement for healthcare professionals from the Cardiac Imaging Committee of the Council on Clinical Cardiology of the American Heart Association. Circulation. 2002;105:539\u201342.","DOI":"10.1161\/hc0402.102975"},{"key":"411_CR14","doi-asserted-by":"crossref","unstructured":"Austen WG, Edwards JE, Frye RL, Gensini GG, Gott LV, Griffith LS, et al. A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation. 1975;51:5\u201340.","DOI":"10.1161\/01.CIR.51.4.5"},{"key":"411_CR15","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1097\/MCA.0b013e3282f2629c","volume":"19","author":"GD Giannoglou","year":"2008","unstructured":"Giannoglou GD, Antoniadis AP, Chatzizisis YS, Damvopoulou E, Parcharidis GE, Louridas GE. Sex-related differences in the angiographic results of 14,500 cases referred for suspected coronary artery disease. Coron Artery Dis. 2008;19:9\u201314.","journal-title":"Coron Artery Dis"},{"key":"411_CR16","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.ahj.2017.06.014","volume":"191","author":"GS Gudnadottir","year":"2017","unstructured":"Gudnadottir GS, Andersen K, Thrainsdottir IS, James SK, Lagerqvist B, Gudnason T. Gender differences in coronary angiography, subsequent interventions, and outcomes among patients with acute coronary syndromes. Am Heart J. 2017;191:65\u201374.","journal-title":"Am Heart J"},{"key":"411_CR17","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.007965","author":"ML Ouellette","year":"2018","unstructured":"Ouellette ML, L\u00f6ffler AI, Beller GA, Workman VK, Holland E, Bourque JM. Clinical characteristics, sex differences, and outcomes in patients with normal or near-normal coronary arteries, non-obstructive or obstructive coronary artery disease. J Am Heart Assoc. 2018. https:\/\/doi.org\/10.1161\/JAHA.117.007965.","journal-title":"J Am Heart Assoc"},{"key":"411_CR18","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1056\/NEJMoa0907272","volume":"362","author":"MR Patel","year":"2010","unstructured":"Patel MR, Peterson ED, Dai D, Brennan JM, Redberg RF, Andersonet HV, et al. Low diagnostic yield of elective coronary angiography. N Engl J Med. 2010;362:886\u201395.","journal-title":"N Engl J Med"},{"key":"411_CR19","doi-asserted-by":"publisher","first-page":"876","DOI":"10.2337\/dc17-2352","volume":"41","author":"V Ritsinger","year":"2018","unstructured":"Ritsinger V, Hero C, Svensson AM, Saleh N, Lagerqvist B, Eeg-Olofssonet K, et al. Characteristics and prognosis in women and men with type 1 diabetes undergoing coronary angiography: a nationwide registry report. Diabetes Care. 2018;41:876\u201383.","journal-title":"Diabetes Care"},{"key":"411_CR20","first-page":"161","volume":"8","author":"J Chiha","year":"2015","unstructured":"Chiha J, Mitchell P, Gopinath B, Plant AJH, Kovoor P, Thiagalingamet A, et al. Gender differences in the severity and extent of coronary artery disease. Int J Cardiol Heart Vasc. 2015;8:161\u20136.","journal-title":"Int J Cardiol Heart Vasc"},{"key":"411_CR21","doi-asserted-by":"publisher","first-page":"1650","DOI":"10.1016\/0735-1097(95)00044-5","volume":"25","author":"MR Bell","year":"1995","unstructured":"Bell MR, Berger PB, Holmes DR Jr, Mullany CJ, Bailey KR, Gersh BJ. Referral for coronary artery revascularization procedures after diagnostic coronary angiography: evidence for gender bias? J Am Coll Cardiol. 1995;25:1650\u20135.","journal-title":"J Am Coll Cardiol"},{"key":"411_CR22","doi-asserted-by":"publisher","first-page":"980","DOI":"10.1016\/j.amjcard.2010.11.020","volume":"107","author":"JE Tamis-Holland","year":"2011","unstructured":"Tamis-Holland JE, Lu J, Bittner V, Lopes N, Adler DS, Kip KE, et al. Sex, clinical symptoms, and angiographic findings in patients with diabetes mellitus and coronary artery disease. J Am Coll Cardiol. 2011;107:980\u20135.","journal-title":"J Am Coll Cardiol"},{"key":"411_CR23","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1136\/heart.89.6.681","volume":"89","author":"N Chaturvedi","year":"2003","unstructured":"Chaturvedi N. Ethnic differences in cardiovascular disease. Heart. 2003;89:681\u20136.","journal-title":"Heart"},{"key":"411_CR24","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1053\/euhj.1999.1941","volume":"21","author":"JE Roeters van Lennep","year":"2000","unstructured":"Roeters van Lennep JE, Zwinderman AH, Roeters van Lennep HW, Westerveld HE, Plokker HW, Voors AA, et al. Gender differences in diagnosis and treatment of coronary artery disease from 1981 to 1997. No evidence for the Yentl syndrome. Eur Heart J. 2000;21:911\u20138.","journal-title":"Eur Heart J"},{"key":"411_CR25","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1177\/000331979004100804","volume":"41","author":"DA Leaf","year":"1990","unstructured":"Leaf DA, Sanmarco ME, Bahl RA. Gender differences in coronary angiographic findings from 1972 through 1981 in Los Angeles, California. Angiology. 1990;41:609\u201315.","journal-title":"Angiology"},{"key":"411_CR26","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1016\/0895-4356(94)00194-U","volume":"48","author":"M Kyriakidis","year":"1995","unstructured":"Kyriakidis M, Petropoulakis P, Androulakis A, Antonopoulos A, Apostolopoulos T, Barbetseas J, et al. Sex differences in the anatomy of coronary artery disease. J Clin Epidemiol. 1995;48:723\u201330.","journal-title":"J Clin Epidemiol"},{"key":"411_CR27","doi-asserted-by":"crossref","first-page":"e011002","DOI":"10.1161\/JAHA.118.011002","volume":"8","author":"CH Kim","year":"2019","unstructured":"Kim CH, Koo BK, Lee JM, Shin ES, Park J, Choi KH, et al. Influence of sex on relationship between total anatomical and physiologic disease burdens and their prognostic implications in patients with coronary artery disease. J Am Heart Assoc. 2019;8:e011002.","journal-title":"J Am Heart Assoc"},{"key":"411_CR28","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s13293-017-0152-8","volume":"8","author":"A Iorga","year":"2017","unstructured":"Iorga A, Cunningham CM, Moazeni S, Ruffenach G, Umar S, Eghbali M. The protective role of estrogen and estrogen receptors in cardiovascular disease and the controversial use of estrogen therapy. Biol Sex Differ. 2017;8:33.","journal-title":"Biol Sex Differ"},{"key":"411_CR29","doi-asserted-by":"publisher","first-page":"2056","DOI":"10.1161\/CIRCULATIONAHA.111.028373","volume":"124","author":"RR Huxley","year":"2011","unstructured":"Huxley RR, Barzi F, Lam TH, Czernichow S, Fang X, Welborn T, et al. Isolated low levels of high-density lipoprotein cholesterol are associated with an increased risk of coronary heart disease: an individual participant data meta-analysis of 23 studies in the Asia-Pacific region. Circulation. 2011;124:2056\u201364.","journal-title":"Circulation"},{"key":"411_CR30","doi-asserted-by":"publisher","first-page":"1787","DOI":"10.1161\/CIRCULATIONAHA.107.726562","volume":"117","author":"LJ Shaw","year":"2008","unstructured":"Shaw LJ, Shaw RE, Merz CN, Brindis RG, Klein LW, Nallamothu B, et al. Impact of ethnicity and gender differences on angiographic coronary artery disease prevalence and in-hospital mortality in the American College of Cardiology-National Cardiovascular Data Registry. Circulation. 2008;117:1787\u2013801.","journal-title":"Circulation"},{"key":"411_CR31","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1016\/j.jcmg.2016.02.007","volume":"9","author":"AS Bharadwaj","year":"2016","unstructured":"Bharadwaj AS, Vengrenyuk Y, Yoshimura T, Baber U, Hasan C, Narul J, et al. Multimodality intravascular imaging to evaluate sex differences in plaque morphology in stable CAD. JACC Cardiovasc Imag. 2016;9:400\u20137.","journal-title":"JACC Cardiovasc Imag"}],"container-title":["Biology of Sex Differences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13293-021-00411-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13293-021-00411-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13293-021-00411-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,21]],"date-time":"2023-01-21T14:36:25Z","timestamp":1674311785000},"score":1,"resource":{"primary":{"URL":"https:\/\/bsd.biomedcentral.com\/articles\/10.1186\/s13293-021-00411-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,3]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["411"],"URL":"https:\/\/doi.org\/10.1186\/s13293-021-00411-1","relation":{},"ISSN":["2042-6410"],"issn-type":[{"value":"2042-6410","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,3]]},"assertion":[{"value":"30 September 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 December 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 January 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol complied with the Declaration of Helsinki, and was approved by the Institutional Review Board of each participating hospital. Written informed consent was obtained from each patient.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that there is no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"2"}}