Sex-Specific Computed Tomography Coronary Plaque Characterization and Risk of Myocardial Infarction.
Williams MC., Kwiecinski J., Doris M., McElhinney P., D'Souza MS., Cadet S., Adamson PD., Moss AJ., Alam S., Hunter A., Shah ASV., Mills NL., Pawade T., Wang C., Weir-McCall JR., Bonnici-Mallia M., Murrills C., Roditi G., van Beek EJR., Shaw LJ., Nicol ED., Berman DS., Slomka PJ., Newby DE., Dweck MR., Dey D.
OBJECTIVES: This study was designed to investigate whether coronary computed tomography angiography assessments of coronary plaque might explain differences in the prognosis of men and women presenting with chest pain. BACKGROUND: Important sex differences exist in coronary artery disease. Women presenting with chest pain have different risk factors, symptoms, prevalence of coronary artery disease and prognosis compared to men. METHODS: Within a multicenter randomized controlled trial, we explored sex differences in stenosis, adverse plaque characteristics (positive remodeling, low-attenuation plaque, spotty calcification, or napkin ring sign) and quantitative assessment of total, calcified, noncalcified and low-attenuation plaque burden. RESULTS: Of the 1,769 participants who underwent coronary computed tomography angiography, 772 (43%) were female. Women were more likely to have normal coronary arteries and less likely to have adverse plaque characteristics (p 4% (41% vs. 59%; p