TY - JOUR
T1 - Sex differences in compositional plaque volume progression in patients with coronary artery disease
AU - Lee, Sang-Eun
AU - Sung, Ji Min
AU - Andreini, Daniele
AU - Al-Mallah, Mouaz H.
AU - Budoff, Matthew J.
AU - Cademartiri, Filippo
AU - Chinnaiyan, Kavitha
AU - Choi, Jung Hyun
AU - Chun, Eun Ju
AU - Conte, Edoardo
AU - Gottlieb, Ilan
AU - Hadamitzky, Martin
AU - Kim, Yong Jin
AU - Lee, Byoung Kwon
AU - Leipsic, Jonathon A.
AU - Maffei, Erica
AU - Marques, Hugo
AU - Gonçalves, Pedro de Araújo
AU - Pontone, Gianluca
AU - Shin, Sanghoon
AU - Stone, Peter H.
AU - Samady, Habib
AU - Virmani, Renu
AU - Narula, Jagat
AU - Berman, Daniel S.
AU - Shaw, Leslee J.
AU - Bax, Jeroen J.
AU - Lin, Fay Y.
AU - Min, James K.
AU - Chang, Hyuk-Jae
N1 - Funding Information:
This work was supported by the Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea funded by the Ministry of Science and ICT (Grant No. 2012027176) (to Dr. Chang). The study was also funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging and the Michael Wolk Foundation. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. Dr. Chang had full access to all the data in the study and had final responsibility for the decision to submit the paper for publication. Dr. Min has received funding from the Dalio Foundation, National Institutes of Health, and GE Healthcare; has served on the scientific advisory board of Arineta and GE Healthcare; and owns equity interest in Cleerly. Dr. Samady has served on the scientific advisory board of Philips; owns equity interest in Covanos Inc.; and has received research grant support from Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Khurram Nasir, MD, served as Guest Editor for this paper.
Publisher Copyright:
© 2020 American College of Cardiology Foundation
PY - 2020/11
Y1 - 2020/11
N2 - Objectives: This study sought to explore sex-based differences in total and compositional plaque volume (PV) progression. Background: It is unclear whether sex has an impact on PV progression in patients with coronary artery disease (CAD). Methods: The study analyzed a prospective multinational registry of consecutive patients with suspected CAD who underwent 2 or more clinically indicated coronary computed tomography angiography (CTA) at ≥2-year intervals. Total and compositional PV at baseline and follow-up were quantitatively analyzed and normalized using the analyzed total vessel length. Multivariate linear regression models were constructed. Results: Of the 1,255 patients included (median coronary CTA interval 3.8 years), 543 were women and 712 were men. Women were older (62 ± 9 years of age vs. 59 ± 9 years of age; p < 0.001) and had higher total cholesterol levels (195 ± 41 mg/dl vs. 187 ± 39 mg/dl; p = 0.002). Prevalence of hypertension, diabetes, and family history of CAD were not different (all p > 0.05). At baseline, men possessed greater total PV (31.3 mm3 [interquartile range (IQR): 0 to 121.8 mm3] vs. 56.7 mm3 [IQR: 6.8 to 152.1 mm3] p = 0.005), and there was an approximately 9-year delay in women in developing total PV than in men. The prevalence of high-risk plaques was greater in men than women (31% vs. 20%; p < 0.001). In multivariate analysis, after adjusting for age, clinical risk factors, medication use, and total PV at baseline, despite similar total PV progression rates, female sex was associated with greater calcified PV progression (β = 2.83; p = 0.004) but slower noncalcified PV progression (β = –3.39; p = 0.008) and less development of high-risk plaques (β = –0.18; p = 0.049) than in men. Conclusions: The compositional PV progression differed according to sex, suggesting that comprehensive plaque evaluation may contribute to further refining of risk stratification according to sex. (NCT02803411).
AB - Objectives: This study sought to explore sex-based differences in total and compositional plaque volume (PV) progression. Background: It is unclear whether sex has an impact on PV progression in patients with coronary artery disease (CAD). Methods: The study analyzed a prospective multinational registry of consecutive patients with suspected CAD who underwent 2 or more clinically indicated coronary computed tomography angiography (CTA) at ≥2-year intervals. Total and compositional PV at baseline and follow-up were quantitatively analyzed and normalized using the analyzed total vessel length. Multivariate linear regression models were constructed. Results: Of the 1,255 patients included (median coronary CTA interval 3.8 years), 543 were women and 712 were men. Women were older (62 ± 9 years of age vs. 59 ± 9 years of age; p < 0.001) and had higher total cholesterol levels (195 ± 41 mg/dl vs. 187 ± 39 mg/dl; p = 0.002). Prevalence of hypertension, diabetes, and family history of CAD were not different (all p > 0.05). At baseline, men possessed greater total PV (31.3 mm3 [interquartile range (IQR): 0 to 121.8 mm3] vs. 56.7 mm3 [IQR: 6.8 to 152.1 mm3] p = 0.005), and there was an approximately 9-year delay in women in developing total PV than in men. The prevalence of high-risk plaques was greater in men than women (31% vs. 20%; p < 0.001). In multivariate analysis, after adjusting for age, clinical risk factors, medication use, and total PV at baseline, despite similar total PV progression rates, female sex was associated with greater calcified PV progression (β = 2.83; p = 0.004) but slower noncalcified PV progression (β = –3.39; p = 0.008) and less development of high-risk plaques (β = –0.18; p = 0.049) than in men. Conclusions: The compositional PV progression differed according to sex, suggesting that comprehensive plaque evaluation may contribute to further refining of risk stratification according to sex. (NCT02803411).
KW - Coronary artery atherosclerosis
KW - Coronary artery disease
KW - Coronary computed tomography angiography
KW - Sex difference
UR - http://www.scopus.com/inward/record.url?scp=85090239235&partnerID=8YFLogxK
U2 - 10.1016/j.jcmg.2020.06.034
DO - 10.1016/j.jcmg.2020.06.034
M3 - Article
C2 - 32828763
AN - SCOPUS:85090239235
SN - 1936-878X
VL - 13
SP - 2386
EP - 2396
JO - JACC: Cardiovascular Imaging
JF - JACC: Cardiovascular Imaging
IS - 11
ER -
