Affordable Access

deepdyve-link
Publisher Website

Coronary artery disease burden in women poorly explained by traditional risk factors: Sex disaggregated analyses from the BioHEART-CT study.

Authors
  • Vernon, Stephen T1
  • Kott, Katharine A1
  • Hansen, Thomas2
  • Zhang, Kimble J3
  • Cole, Ben R4
  • Coffey, Sean5
  • Grieve, Stuart M6
  • Figtree, Gemma A7
  • 1 Cardiovascular Discovery Group, Kolling Institute of Medical Research, University of Sydney, Australia; Department of Cardiology, Royal North Shore Hospital, Australia; Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Australia. , (Australia)
  • 2 Cardiovascular Discovery Group, Kolling Institute of Medical Research, University of Sydney, Australia; Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Australia. , (Australia)
  • 3 Faculty of Science, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia. , (Australia)
  • 4 Cardiology Department, Royal Victoria Hospital, Belfast, Northern Ireland, UK. , (Ireland)
  • 5 Dunedin School of Medicine University of Otago Dunedin New Zealand, New Zealand. , (New Zealand)
  • 6 Imaging and Phenotyping Laboratory, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Australia; Department of Radiology, Royal Prince Alfred Hospital, Sydney, Australia. , (Australia)
  • 7 Cardiovascular Discovery Group, Kolling Institute of Medical Research, University of Sydney, Australia; Department of Cardiology, Royal North Shore Hospital, Australia; Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Australia; Charles Perkins Centre, University of Sydney, Australia. Electronic address: [email protected] , (Australia)
Type
Published Article
Journal
Atherosclerosis
Publication Date
Sep 01, 2021
Volume
333
Pages
100–107
Identifiers
DOI: 10.1016/j.atherosclerosis.2021.05.004
PMID: 34045070
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Targeting the modifiable risk factors for coronary artery disease (CAD) has substantial impact at the community level. However, it is not uncommon for individuals to present with atherosclerosis related events without identified risk factors. We examined sex differences in the association of risk factors and atherosclerotic burden assessed by CT coronary angiography (CTCA). We analysed clinical and imaging data in 1002 individuals in the BioHEART cohort. 45% were female, 35% had no CAD identified. Median coronary calcium score was 9.9 Agatston units (IQR: 0-146), and median Gensini Score was 3.5 (IQR: 0-11.5). 26% had a calcified plaque predominant phenotype, and 18% had a non-calcified plaque predominant phenotype. There were no sex differences in the prevalence of risk factors. However, there were notable sex differences in the adjusted associations of risk factors with CAD. Age and hypercholesterolaemia (OR 1.56, 95% CI 1.03-2.36, p = 0.04 in males, and OR 1.75, 95% CI 1.09-2.78, p = 0.02 in females) were associated with the presence of CAD in both genders (p < 0.05). Diabetes and smoking were associated with presence of CAD, calcified CAD, and non-calcified plaque in males (p < 0.05) but not females. In women, none of the standard modifiable risk factors were associated with the amount of plaque present when adjusted for age, BMI, and family history of premature CAD. CTCA provides an important opportunity for improving the stratification of cohorts to assess underlying biology and risk. We demonstrate sex-specific differences in associations of risk factors with atherosclerosis burden. Copyright © 2021. Published by Elsevier B.V.

Report this publication

Statistics

Seen <100 times