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Sex differences in coronary plaque changes assessed by serial computed tomography angiography
Mohammed El Mahdiui1, Jeff M Smit1, Alexander R van Rosendael1
1Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2300 RC, Leiden, The Netherlands.
The International Journal of Cardiovascular Imaging
|March 11, 2021
Summary
In stable coronary artery disease (CAD), men showed more fibro-fatty plaque, while younger women experienced plaque regression. No overall sex differences in plaque volume increase were found.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Long-term sex differences in coronary plaque progression in stable coronary artery disease (CAD) are not well-documented.
- Understanding these differences is crucial for personalized risk assessment and treatment strategies.
Purpose of the Study:
- To investigate sex-based differences in long-term coronary plaque progression and composition.
- To evaluate the influence of menopause on plaque changes over time.
Main Methods:
- Prospective inclusion of stable CAD patients undergoing serial coronary computed tomography angiography (CTA).
- Normalization of plaque volumes to vessel volume to calculate percentage atheroma volume (PAV).
- Stratification of patients by age (55 years) to assess menopausal influence.
Main Results:
- No significant sex differences in the overall increase of percentage atheroma volume (PAV) were observed over time.
- Women consistently had lower fibro-fatty PAV compared to men.
- Women under 55 years showed significant regression of fibrous and non-calcified PAV, unlike men.
Conclusions:
- In low-to-intermediate risk stable CAD, sex does not significantly impact total plaque volume increase over time.
- Women exhibit distinct plaque composition and regression patterns, particularly pre-menopause.
- Menopause status influences plaque evolution, highlighting the need for sex-specific considerations in CAD management.
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