Sex and age-specific interactions of coronary atherosclerotic plaque onset and prognosis from coronary computed tomography
An erratum to this article was published (Eur Heart J Cardiovasc Imaging, 27 Oct 2023 ↗)
Authors' conclusion
Women developed coronary atherosclerosis approximately 12 years later than men. Post-menopausal women within the highest atherosclerotic burden group were at significantly higher risk for MACE than their male counterparts
Study context
- Population
- Individuals undergoing coronary CT angiography in a large multicentre registry
- Participants
- 24,950 individuals
- Exposure
- Women vs men
- Womenn = 11,678
- Menn = 13,272reference
- Outcome
- MACE (death or MI) by Leiden coronary computed tomography angiography (CCTA) score; age of plaque onset
- Follow-up
- 3.7 years
Main finding
As reported in the abstract
MACE by Leiden CCTA score
Hazard ratio (CI)
Womenvs Menscore 6-20
2.29(1.69–3.10)
Womenvs Menscore > 20
6.71(4.36–10.32)
Menscore 6-20
1.64(1.29–2.08)
Menscore > 20
2.38(1.73–3.29)
- Age where median risk score above zero 12 years higher in women vs men (64-68 vs 52-56 years)
- P < 0.001
- Risk significantly higher for women in highest score group
- adjusted P-interaction = 0.003
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| MACE by score, post-menopausal women vs men (subgroup)Womenvs MenPost-menopausal, score 6-20 | 2.21 (1.57–3.11) | |
| MACE by score, post-menopausal women vs men (subgroup)Womenvs MenPost-menopausal, score > 20 | 6.11 (3.84–9.70) | |
| 0.10.31310Hazard ratio (log scale) |
Major adverse cardiovascular events (MACE) by score, post-menopausal women vs men (subgroup)
| HR (CI) | ||
|---|---|---|
| MenScore 6-20 | 1.57 (1.19–2.09) | |
| MenScore > 20 | 2.25 (1.58–3.22) | |
| 0.20.5125Hazard ratio (log scale) |
- MACE by score, post-menopausal women vs men (subgroup): adjusted P-interaction = 0.004 (highest risk group)
MACE by score, pre-menopausal women (subgroup)
- Risk score equally predictive and comparable with men
Original publication
Sex and age-specific interactions of coronary atherosclerotic plaque onset and prognosis from coronary computed tomography. Eur Heart J Cardiovasc Imaging. Published 11 May 2023. doi:10.
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