Sex Differences in Coronary Artery Disease Characteristics Among Patients With Type 2 Myocardial Infarction

Area of Science:

• Cardiology
• Medical Imaging
• Public Health

Background:

• Type 2 myocardial infarction (MI) stems from coronary supply and demand imbalance, carrying a poor prognosis.
• Identifying sex-based differences in coronary artery disease (CAD) in type 2 MI patients is critical.

Purpose of the Study:

• To investigate sex-based disparities in CAD prevalence and characteristics among patients experiencing type 2 MI.
• Utilize coronary computed tomography angiography (CCTA) and fractional flow reserve (FFR) for evaluation.

Main Methods:

• Prospective, single-center study involving patients with adjudicated type 2 MI.
• Coronary computed tomography angiography (CCTA) with fractional flow reserve (FFR) was performed on 50 participants (50% women).

Main Results:

• No significant sex differences were observed in the prevalence of any CAD (84% vs 100%), obstructive CAD (24% vs 28%), or hemodynamically significant stenosis (20% vs 32%).
• While total plaque volume was similar, women exhibited significantly lower levels of low-attenuation plaque (median 3 vs 9).
• ST-segment depression was more frequent in women (64% vs 32%), whereas T-wave inversion was more common in men (68% vs 36%).

Conclusions:

• Sex does not appear to influence the prevalence of any or obstructive CAD in type 2 MI patients.
• Women with type 2 MI demonstrated a lower volume of low-attenuation plaque compared to men, despite similar overall plaque burden.