Sex Differences in Compositional Plaque Volume Progression in Patients With Coronary Artery Disease

被引：30

作者：

Lee, Sang-Eun ^{[1
,2
]}

Sung, Ji Min ^{[2
,3
]}

Andreini, Daniele ^{[4
]}

Al-Mallah, Mouaz H. ^{[5
]}

Budoff, Matthew J. ^{[6
]}

Cademartiri, Filippo ^{[7
]}

Chinnaiyan, Kavitha ^{[8
]}

Choi, Jung Hyun ^{[9
]}

Chun, Eun Ju ^{[10
]}

Conte, Edoardo ^{[4
]}

Gottlieb, Ilan ^{[11
]}

Hadamitzky, Martin ^{[12
]}

Kim, Yong Jin ^{[13
]}

Lee, Byoung Kwon ^{[14
]}

Leipsic, Jonathon A. ^{[15
]}

Maffei, Erica ^{[16
]}

Marques, Hugo ^{[17
]}

Goncalves, Pedro de Araujo ^{[17
]}

Pontone, Gianluca ^{[4
]}

Shin, Sanghoon ^{[1
]}

Stone, Peter H. ^{[18
]}

Samady, Habib ^{[19
]}

Virmani, Renu ^{[20
]}

Narula, Jagat ^{[21
]}

Berman, Daniel S. ^{[22
]}

Shaw, Leslee J. ^{[23
,24
]}

Bax, Jeroen J. ^{[25
]}

Lin, Fay Y. ^{[23
,24
]}

Min, James K. ^{[23
,24
]}

Chang, Hyuk-Jae ^{[2
,3
]}

机构：

[1] Ewha Womans Univ, Coll Med, Dept Internal Med, Div Cardiol, Seoul, South Korea

[2] Yonsei Univ, Yonsei Univ Hlth Syst, Yonsei Cedars Sinai Integrat Cardiovasc Imaging R, Coll Med, Seoul, South Korea

[3] Yonsei Univ, Yonsei Univ Hlth Syst, Severance Cardiovasc Hosp, Div Cardiol,Coll Med, 50-1 Yonsei Ro, Seoul 03722, South Korea

[4] Ist Ricovero & Cura Carattere Sci, Ctr Cardiol Monzino, Milan, Italy

[5] Houston Methodist Hosp, Houston Methodist DeBakey Heart & Vasc Ctr, Houston, TX USA

[6] Los Angeles Biomed Res Inst, Dept Med, Torrance, CA USA

[7] SDN Ist Ricovero & Cura Carattere Sci, Cardiovasc Imaging Unit, Naples, Italy

[8] William Beaumont Hosp, Dept Cardiol, Royal Oak, MI USA

[9] Pusan Univ Hosp, Dept Internal Med, Busan, South Korea

[10] Seoul Natl Univ, Dept Radiol, Bundang Hosp, Seongnam, South Korea

[11] Casa Saude Sao Jose, Dept Radiol, Rio De Janeiro, Brazil

[12] German Heart Ctr Munich, Dept Radiol & Nucl Med, Munich, Germany

[13] Seoul Natl Univ, Seoul Natl Univ Hosp, Cardiovasc Ctr, Dept Internal Med,Coll Med, Seoul, South Korea

[14] Yonsei Univ, Gangnam Severance Hosp, Dept Internal Med, Coll Med, Seoul, South Korea

[15] Univ British Columbia, Dept Med & Radiol, Vancouver, BC, Canada

[16] Azienda Sanitaria Unica Reg Marche, Dept Radiol, Area Vasta 1, Urbino, Italy

[17] Hosp Luz, Unit Cardiovasc Imaging, Lisbon, Portugal

[18] Brigham & Womens Hosp, Div Cardiovasc Med, Boston, MA USA

[19] Emory Univ, Sch Med, Div Cardiol, Atlanta, GA 30322 USA

[20] CVPath Inst, Dept Pathol, Gaithersburg, MD USA

[21] Icahn Sch Med Mt Sinai, Dept Med, New York, NY USA

[22] Cedars Sinai Med Ctr, Dept Imaging & Med, Los Angeles, CA USA

[23] New York Presbyterian Hosp, Dept Radiol, New York, NY USA

[24] Weill Cornell Med, New York, NY USA

[25] Leiden Univ, Dept Cardiol, Med Ctr, Leiden, Netherlands

来源：

JACC-CARDIOVASCULAR IMAGING | 2020年 / 13卷 / 11期

基金：

美国国家卫生研究院; 新加坡国家研究基金会;

关键词：

coronary artery atherosclerosis; coronary artery disease; coronary computed tomography angiography; sex difference; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; INTRAVASCULAR ULTRASOUND; MYOCARDIAL-INFARCTION; CLINICAL-OUTCOMES; CALCIFIED NODULE; SCCT GUIDELINES; CT ANGIOGRAPHY; HEART-DISEASE; ATHEROSCLEROSIS; CALCIUM;

D O I：

10.1016/j.jcmg.2020.06.034

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 mm(3) [interquartile range (IQR): 0 to 121.8 mm(3)] vs. 56.7 mm(3) [IQR: 6.8 to 152.1 mm(3)] 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 (b = 2.83; p = 0.004) but slower noncalcified PV progression (b = -3.39; p = 0.008) and less development of high-risk plaques (b = -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. (c) 2020 by the American College of Cardiology Foundation.

引用

页码：2386 / 2396

页数：11

共 40 条

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