Based on a study recently presented at the annual meeting of the Radiological Society of North America (RSNA), an examination of data from an international multicenter study of coronary computed tomography angiography (CCTA) shows that men and women with mild coronary artery disease and similar cardiovascular risk profiles share similar diagnoses.
“We conducted this study because we wanted to understand whether men and women with the same extent of coronary artery disease and similar risk profiles have similar or dissimilar prognoses. There is a tendency to think women's heart disease is very different than men's heart disease. Our data show that once plaque accumulates in the coronary arteries, the prognosis is very similar between men and women,” said director of medical imaging at St. Paul's Hospital in Vancouver, British Columbia, Jonathon Leipsic, M.D., FRCPC.
Coronary artery disease takes place when the coronary arteries, the key blood vessels that provide the oxygen-rich blood to the heart muscle, start to amass a buildup of fatty deposits called plaque. Over time, plaque may damage or narrow the arteries. CCTA is a noninvasive imaging test that employs computed tomography (CT) to image the quantity of plaque existing in the coronary arteries.
For the study, Leipsic and a team of researchers used data from the Coronary CT Angiography Evaluation For Clinical Outcomes: An InteRnational Multicenter (CONFIRM) Registry, which composed information on 27,725 individuals in six countries who received CCTA.
The registry also included participants' traditional risk factors, allowing for the derivation of Framingham scores, which are used to gauge an individual's risk of developing cardiovascular disease.
From the registry, the researchers found 18,158 patients without known coronary artery disease, whose CCTA results were normal or indicated nonobstructive disease, in which coronary arteries were less than 50 percent blocked. These patients, including 8,808 women and 9,350 men, were then paired on the account of pre-existing cardiovascular risk factors and the degree of their coronary artery disease as assessed by CCTA, resulting in a one-to-one group of 11,462 patients.
A statistical analysis of the paired group showed that, controlling for all cardiovascular risk factors, nonobstructive coronary artery disease presented a similar adverse risk of death or heart attack in both men and women. On the other hand, the absence of plaque on CCTA presented a good diagnosis for both men and women. Of the patients in the group, only 251 experienced a heart attack or cardiac-related death during a median follow-up period of 2.3 years.
"This analysis is exciting, because this has never been shown before. There's a prevailing belief that mild CAD puts women at greater risk for a major cardiac event compared to men with mild CAD. Our findings show this is just not true,” said Leipsic.