Sex- and Age-Specific Interactions of Coronary Atherosclerotic Plaque Onset and Prognosis From CCTA
TAKE-HOME MESSAGE
- In this analysis of data from a large multicenter CCTA registry, women developed coronary atherosclerosis approximately 12 years later than men (64–68 vs 52–56 years). Postmenopausal women with the highest burden of coronary atherosclerosis were at a substantially higher risk of major adverse cardiovascular events than their male counterparts.
- These findings highlight the important sex-specific trends in the development of coronary atherosclerosis.
abstract
This abstract is available on the publisher's site.
Access this abstract nowAIMS
The totality of atherosclerotic plaque derived from coronary computed tomography angiography (CCTA) emerges as a comprehensive measure to assess the intensity of medical treatment that patients need. This study examines the differences in age onset and prognostic significance of atherosclerotic plaque burden between sexes.
METHODS AND RESULTS
From a large multi-center CCTA registry the Leiden CCTA score was calculated in 24 950 individuals. A total of 11 678 women (58.5 ± 12.4 years) and 13 272 men (55.6 ± 12.5 years) were followed for 3.7 years for major adverse cardiovascular events (MACE) (death or myocardial infarction). The age where the median risk score was above zero was 12 years higher in women vs. men (64-68 years vs. 52-56 years, respectively, P < 0.001). The Leiden CCTA risk score was independently associated with MACE: score 6-20: HR 2.29 (1.69-3.10); score > 20: HR 6.71 (4.36-10.32) in women, and score 6-20: HR 1.64 (1.29-2.08); score > 20: HR 2.38 (1.73-3.29) in men. The risk was significantly higher for women within the highest score group (adjusted P-interaction = 0.003). In pre-menopausal women, the risk score was equally predictive and comparable with men. In post-menopausal women, the prognostic value was higher for women [score 6-20: HR 2.21 (1.57-3.11); score > 20: HR 6.11 (3.84-9.70) in women; score 6-20: HR 1.57 (1.19-2.09); score > 20: HR 2.25 (1.58-3.22) in men], with a significant interaction for the highest risk group (adjusted P-interaction = 0.004).
CONCLUSION
Women developed coronary atherosclerosis approximately 12 years later than men. Post-menopausal women within the highest atherosclerotic burden group were at significantly higher risk for MACE than their male counterparts, which may have implications for the medical treatment intensity.
Click on any of these tags to subscribe to Topic Alerts. Once subscribed, you can get a single, daily email any time PracticeUpdate publishes content on the topics that interest you.
Visit your Preferences and Settings section to Manage All Topic Alerts
Additional Info
Sex and age-specific interactions of coronary atherosclerotic plaque onset and prognosis from coronary computed tomography
Eur Heart J Cardiovasc Imaging 2023 May 11;[EPub Ahead of Print], SE van Rosendael, AM Bax, FY Lin, S Achenbach, D Andreini, MJ Budoff, F Cademartiri, TQ Callister, K Chinnaiyan, BJW Chow, RC Cury, AJ DeLago, G Feuchtner, M Hadamitzky, J Hausleiter, PA Kaufmann, YJ Kim, JA Leipsic, E Maffei, H Marques, P de Araújo Gonçalves, G Pontone, GL Raff, R Rubinshtein, TC Villines, HJ Chang, DS Berman, JK Min, JJ Bax, LJ Shaw, AR van RosendaelFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.