Sex Differences in Aortic Arch Calcification With Zero Coronary Artery Calcium

Area of Science:

• Cardiovascular Imaging
• Atherosclerosis Research
• Sex Differences in Health

Background:

• Aortic calcification is linked to increased mortality.
• Limited data exists on sex differences in aortic arch calcification (AAC) relative to coronary artery calcium (CAC).

Purpose of the Study:

• To investigate sex differences in AAC prevalence and severity.
• To examine AAC in relation to zero CAC.
• To assess AAC as a potential contributor to sex disparities in cardiovascular disease.

Main Methods:

• Utilized data from 2,564 Multi-Ethnic Study of Atherosclerosis (MESA) participants.
• Measured CAC and AAC using computed tomography and the Agatston method.
• Employed regression analysis to evaluate sex differences, adjusting for covariates.

Main Results:

• Women showed higher AAC prevalence (87% vs 80% in zero CAC; 92% vs 90% overall).
• Median AAC was higher in women across both populations.
• Adjusted analysis revealed significantly lower average AAC in men compared to women (0.51 times) in the zero CAC group.

Conclusions:

• Women exhibit a higher prevalence of aortic arch calcification compared to men.
• In individuals with zero coronary artery calcium, women have significantly greater aortic arch calcification.
• Further research is needed to determine if these AAC sex differences explain cardiovascular disease event prediction disparities.