Sex Differences in Coronary Arterial Calcification in Symptomatic Patients
Section snippets
Methods
This retrospective cohort study was approved by the IRB of Northwell Health. Our study included all patients ≥ 18 years of age, who presented to the ED of North Shore University Hospital between January 2016 and December 2017 with chest pain suggesting possible coronary artery disease (CAD) and who received coronary computed tomography angiography (CCTA) which included a CAC score. Race was categorized as Caucasian, Black, Asian, and other. Hypertension and hyperlipidemia were considered to be
Results
From January 2016 to December 2017, a total of 542 patients had CCTA done with a CAC score quantified. Baseline demographic and clinical characteristics are shown in Table 1. There were 263 men (48.5%) and 279 women (51.5%) in the study population. Women were generally older (p = 0.026) and had a higher percentage of mild decrease in creatinine clearance (p=0.02) while men were more often smokers (p < 0.001) and more likely to have hyperlipidemia (p=0.013). A higher percentage of women were
Discussion
Acute coronary syndrome is usually a consequence of thromboembolic events due to atherosclerosis and plaque rupture. Sex difference in CAD development is multifactorial and includes hormonal differences, differences in vascular beds, and atherosclerotic characteristics. Despite increasing interest in sex-specific evidence to improve outcomes, our understanding of sex differences in atherosclerosis remains suboptimal.10 In this study, we report on sex-specific risk factor analysis and vessel
Conclusion
Our study demonstrates that sex is the most powerful predictor for higher CAC score among traditional cardiovascular risk factors in symptomatic patients, and men also tend to have more diffuse CAD compared to women. In addition, we showed that there is a sex difference in the contribution of various traditional risk factors to elevated CAC score, as obesity was the most powerful predictor in men, while smoking and diabetes had higher impact on CAC score in women.
Conflict of Interest
Conflict of Interest for all authors: None
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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Cited by (0)
Author Contribution: Beom Soo Kim: Conceptualization, Methodology, Investigation, Data Curation, Formal analysis, Writing – Original draft preparation, Visualization Nicholas Chan: Investigation Greg Hsu: investigation Amgad N. Makaryus: Review & Editing, Maya Chopra: Investigation Stuart Cohen: Data Curation, Writing – Review & Editing, Supervision John N. Makaryus: Data Curation, Writing – Review & Editing, Supervision