Coronary plaque affects women more than men

Women with large amounts of plaque build-up and extensive thickening of the artery walls are at a significantly greater cardiovascular risk than men, a new study has found. According to researchers at the Medical University, finding on coronary CT angiography (CTA), a noninvasive test to assess the coronary arteries for blockages, shows different risk scenarios for men and women. Coronary artery disease (CAD) is a narrowing of the blood vessels that supply blood and oxygen to the heart. It is caused by a build-up of fat and other substances that form plaque on vessel walls. The researchers analysed the results of coronary CTA on 480 patients, mean age 55, with acute chest pain. Approximately 65 per cent of the patients were women, and 35 percent were men. The possibility of acute coronary syndrome was ruled out for each of the patients. Using coronary CTA, the researchers were able to determine the number of vessel segments with plaque, the severity of the blockage and the composition of the plaque. "The latest CT scanners are able to produce images that allow us to determine whether the plaque is calcified, non-calcified or mixed," John W. Nance Jr., M.D., currently a radiology resident at Johns Hopkins Hospital in Baltimore, said. By comparing the coronary CTA results with outcome data over a 12.8-month follow-up period, the researchers were able to correlate the extent, severity and type of plaque build-up with the occurrence of major adverse cardiac events, such as a heart attack or coronary bypass surgery. The statistical analysis tested all plaques combined (calcified, non-calcified and mixed) and each individual plaque type separately. "We found that the risks for cardiovascular events associated with plaque were significantly different between women and men," he said. Within the follow-up period, 70 of the patients experienced major adverse cardiac events, such as death, heart attack, unstable angina or revascularization. In total, 87 major adverse cardiac events occurred among the patients during the follow-up period. When the outcome data were correlated with the CTA combined plaque findings, the results indicated that women with a large amount of plaque build-up and extensive atherosclerosis are at significantly greater cardiovascular risk than men. Specifically, the risk for major adverse cardiac events was significantly higher in women than in men when extensive plaque of any kind was present or when more than four artery segments were narrowed. "This research tells us that extensive coronary plaque is more worrisome in women than the equivalent amount in men," Nance said.