Abstract
Purpose:
The objective of this study was to assess whether sex differences exist in plaque burden and plaque subtype as assessed by coronary computed tomography angiography (CCTA).
Methods:
The study cohort included 937 consecutive patients who underwent CCTA between 2008 and 2010. Stenosis was quantified using the Society of Cardiovascular Computed Tomography stenosis grading scale and a total stenosis score (TSS) was generated. Plaque morphology (PM) was reported as predominantly calcified (CP), noncalcified (NCP), or mixed (MP) plaque, and CP, NCP, and MP percentages were calculated.
Results:
On multivariate analysis, men were significantly more likely to have plaque (65.9% of men vs. 44.6% of women, p<0.001), at least one segment with ≥50% stenosis (22.7% of men vs. 10.3% of women, p<0.001) and higher TSS (mean score=2.81 for men vs. 1.58 for women, p<0.001). Sex was the strongest predictor in all models (odds ratio [OR]=2.55, 95% confidence interval [CI] 1.78–3.67, p<0.001 for any plaque; OR=2.48, 95% CI 1.48–4.16, p<0.01 for segments with ≥50% stenosis; β=1.46, 95% CI 0.69–2.22, p<0.001 for TSS). Among patients with coronary plaque present, no significant sex differences in PM were found.
Conclusions:
Sex was the strongest risk factor for the presence and extent of plaque. Significant sex differences in PM did not exist.
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