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Sex differences in coronary atherosclerosis progression and major adverse cardiac events in patients with suspected coronary artery disease.
J Cardiovasc Comput Tomogr. 2017 Sep - Oct; 11(5):367-372.JC

Abstract

BACKGROUND

Little is known about the influence of coronary atherosclerosis progression on the risk of major adverse cardiac events (MACE). Similarly, differences between men and women regarding atherosclerosis progression are poorly understood. The purpose of this study was to investigate the progression of coronary atherosclerosis by coronary CT angiography (coronary CTA) in men and women, and to evaluate its prognostic value regarding MACE.

METHODS

This study included 1046 patients with suspected coronary artery disease (CAD) who underwent serial coronary CTA because of new or worsening symptoms or because follow-up coronary CTA had been recommended by attending physicians. Coronary atherosclerosis was semi-quantitatively assessed as follows: three-vessel plaque score (TVPS), severe proximal plaque score (SPPS), segment stenosis score (SSS), segment involvement score (SIS), and coronary artery calcium score (CACS). Patients were followed-up regarding the occurrence of MACE, defined as cardiac death, coronary revascularization, nonfatal myocardial infarction and hospitalization due to unstable angina. Follow-up information was gathered by clinical visits or telephone contacts.

RESULTS

Follow-up was achieved in 953 (91.1%) patients (63.8% male; mean age, 53.9 ± 9.7 years) with a mean interval of 4.9 ± 1.1 years. MACE occurred in 132 (13.9%) patients. The average interscan time was 2.1 years. Compared with women, men had significantly higher progression of SPPS, SSS and SIS (6.6% vs. 3.5%, 28.0% vs. 18.3%, 26.6% vs. 16.8%, respectively, all P < 0.005). There was a strong association between the progression of SPPS as well as SSS and MACE, both for men (SPPS, HR:2.17, P < 0.001; SSS, HR:1.28, P = 0.023) and women (SPPS, HR:2.75, P < 0.001; SSS, HR:1.19, P = 0.027).

CONCLUSIONS

Progression of coronary atherosclerosis as determined by coronary CTA is higher in men than women, it is associated with the risk of future MACE.

Authors+Show Affiliations

Shandong Medical Imaging Research Institute, Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Disease, Shandong University, #324 Jingwu Road, Jinan, 250021, PR China; Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, #167 Bei-Li-Shi Street, Beijing, 100037, PR China.Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, #167 Bei-Li-Shi Street, Beijing, 100037, PR China.Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, #167 Bei-Li-Shi Street, Beijing, 100037, PR China.Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, #167 Bei-Li-Shi Street, Beijing, 100037, PR China.Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, #167 Bei-Li-Shi Street, Beijing, 100037, PR China.Shandong Medical Imaging Research Institute, Shandong Provincial Key Laboratory of Diagnosis and Treatment of Cardio-Cerebral Vascular Disease, Shandong University, #324 Jingwu Road, Jinan, 250021, PR China. Electronic address: wangximing_369@sina.com.Department of Radiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, #167 Bei-Li-Shi Street, Beijing, 100037, PR China. Electronic address: bluvip@126.com.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

28754436

Citation

Gu, Hui, et al. "Sex Differences in Coronary Atherosclerosis Progression and Major Adverse Cardiac Events in Patients With Suspected Coronary Artery Disease." Journal of Cardiovascular Computed Tomography, vol. 11, no. 5, 2017, pp. 367-372.
Gu H, Gao Y, Wang H, et al. Sex differences in coronary atherosclerosis progression and major adverse cardiac events in patients with suspected coronary artery disease. J Cardiovasc Comput Tomogr. 2017;11(5):367-372.
Gu, H., Gao, Y., Wang, H., Hou, Z., Han, L., Wang, X., & Lu, B. (2017). Sex differences in coronary atherosclerosis progression and major adverse cardiac events in patients with suspected coronary artery disease. Journal of Cardiovascular Computed Tomography, 11(5), 367-372. https://doi.org/10.1016/j.jcct.2017.07.002
Gu H, et al. Sex Differences in Coronary Atherosclerosis Progression and Major Adverse Cardiac Events in Patients With Suspected Coronary Artery Disease. J Cardiovasc Comput Tomogr. 2017 Sep - Oct;11(5):367-372. PubMed PMID: 28754436.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sex differences in coronary atherosclerosis progression and major adverse cardiac events in patients with suspected coronary artery disease. AU - Gu,Hui, AU - Gao,Yang, AU - Wang,Haiping, AU - Hou,Zhihui, AU - Han,Lei, AU - Wang,Ximing, AU - Lu,Bin, Y1 - 2017/07/16/ PY - 2017/05/25/received PY - 2017/07/14/accepted PY - 2017/7/30/pubmed PY - 2018/6/5/medline PY - 2017/7/30/entrez KW - Coronary atherosclerosis KW - Major adverse cardiac events KW - Plaque progression KW - Sex differences SP - 367 EP - 372 JF - Journal of cardiovascular computed tomography JO - J Cardiovasc Comput Tomogr VL - 11 IS - 5 N2 - BACKGROUND: Little is known about the influence of coronary atherosclerosis progression on the risk of major adverse cardiac events (MACE). Similarly, differences between men and women regarding atherosclerosis progression are poorly understood. The purpose of this study was to investigate the progression of coronary atherosclerosis by coronary CT angiography (coronary CTA) in men and women, and to evaluate its prognostic value regarding MACE. METHODS: This study included 1046 patients with suspected coronary artery disease (CAD) who underwent serial coronary CTA because of new or worsening symptoms or because follow-up coronary CTA had been recommended by attending physicians. Coronary atherosclerosis was semi-quantitatively assessed as follows: three-vessel plaque score (TVPS), severe proximal plaque score (SPPS), segment stenosis score (SSS), segment involvement score (SIS), and coronary artery calcium score (CACS). Patients were followed-up regarding the occurrence of MACE, defined as cardiac death, coronary revascularization, nonfatal myocardial infarction and hospitalization due to unstable angina. Follow-up information was gathered by clinical visits or telephone contacts. RESULTS: Follow-up was achieved in 953 (91.1%) patients (63.8% male; mean age, 53.9 ± 9.7 years) with a mean interval of 4.9 ± 1.1 years. MACE occurred in 132 (13.9%) patients. The average interscan time was 2.1 years. Compared with women, men had significantly higher progression of SPPS, SSS and SIS (6.6% vs. 3.5%, 28.0% vs. 18.3%, 26.6% vs. 16.8%, respectively, all P < 0.005). There was a strong association between the progression of SPPS as well as SSS and MACE, both for men (SPPS, HR:2.17, P < 0.001; SSS, HR:1.28, P = 0.023) and women (SPPS, HR:2.75, P < 0.001; SSS, HR:1.19, P = 0.027). CONCLUSIONS: Progression of coronary atherosclerosis as determined by coronary CTA is higher in men than women, it is associated with the risk of future MACE. SN - 1876-861X UR - https://www.unboundmedicine.com/medline/citation/28754436/Sex_differences_in_coronary_atherosclerosis_progression_and_major_adverse_cardiac_events_in_patients_with_suspected_coronary_artery_disease_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1934-5925(17)30166-1 DB - PRIME DP - Unbound Medicine ER -