A1 Refereed original research article in a scientific journal
Sex differences in coronary plaque changes assessed by serial computed tomography angiography
Authors: El Mahdiui Mohammed, Smit Jeff M., van Rosendael Alexander R., Neglia Danilo, Knuuti Juhani, Saraste Antti, Buechel Ronny R., Teresinska Anna, Pizzi Maria N., Roque Albert, Magnacca Massimo, Mertens Bart J., Caselli Chiara, Rocchiccioli Silvia, Parodi Oberdan, Pelosi Gualtiero, Scholte Arthur J.
Publisher: SPRINGER
Publication year: 2021
Journal: International Journal of Cardiovascular Imaging
Journal name in source: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING
Journal acronym: INT J CARDIOVAS IMAG
Volume: 37
First page : 2311
Last page: 2321
Number of pages: 11
ISSN: 1569-5794
eISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-021-02204-4
Web address : https://doi.org/10.1007/s10554-021-02204-4
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/53658957
Long-term data on sex-differences in coronary plaque changes over time is lacking in a low-to-intermediate risk population of stable coronary artery disease (CAD). The aim of this study was to evaluate the role of sex on long-term plaque progression and evolution of plaque composition. Furthermore, the influence of menopause on plaque progression and composition was also evaluated. Patients that underwent a coronary computed tomography angiography (CTA) were prospectively included to undergo a follow-up coronary CTA. Total and compositional plaque volumes were normalized using the vessel volume to calculate a percentage atheroma volume (PAV). To investigate the influence of menopause on plaque progression, patients were divided into two groups, under and over 55 years of age. In total, 211 patients were included in this analysis, 146 (69%) men. The mean interscan period between baseline and follow-up coronary CTA was 6.2 +/- 1.4 years. Women were older, had higher HDL levels and presented more often with atypical chest pain. Men had 434 plaque sites and women 156. On a per-lesion analysis, women had less fibro-fatty PAV compared to men (beta -1.3 +/- 0.4%; p < 0.001), with no other significant differences. When stratifying patients by 55 years age threshold, fibro-fatty PAV remained higher in men in both age groups (p < 0.05) whilst women younger than 55 years demonstrated more regression of fibrous (beta -0.8 +/- 0.3% per year; p = 0.002) and non-calcified PAV (beta -0.7 +/- 0.3% per year; p = 0.027). In a low-to-intermediate risk population of stable CAD patients, no significant sex differences in total PAV increase over time were observed. Fibro-fatty PAV was lower in women at any age and women under 55 years demonstrated significantly greater reduction in fibrous and non-calcified PAV over time compared to age-matched men. (ClinicalTrials.gov number, NCT04448691.)
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