Sex Differences in Compositional Plaque Volume Progression in Patients With Coronary Artery Disease

Sang Eun Lee; Ji Min Sung; Daniele Andreini; Mouaz H. Al-Mallah; Matthew J. Budoff; Filippo Cademartiri; Kavitha Chinnaiyan; Jung Hyun Choi; Eun Ju Chun; Edoardo Conte; Ilan Gottlieb; Martin Hadamitzky; Yong Jin Kim; Byoung Kwon Lee; Jonathon A. Leipsic; Erica Maffei; Hugo Marques; Pedro de Araújo Gonçalves; Gianluca Pontone; Sanghoon Shin; Peter H. Stone; Habib Samady; Renu Virmani; Jagat Narula; Daniel S. Berman; Leslee J. Shaw; Jeroen J. Bax; Fay Y. Lin; James K. Min; Hyuk Jae Chang

doi:10.1016/j.jcmg.2020.06.034

Sex Differences in Compositional Plaque Volume Progression in Patients With Coronary Artery Disease

Sang Eun Lee, Ji Min Sung, Daniele Andreini, Mouaz H. Al-Mallah, Matthew J. Budoff, Filippo Cademartiri, Kavitha Chinnaiyan, Jung Hyun Choi, Eun Ju Chun, Edoardo Conte, Ilan Gottlieb, Martin Hadamitzky, Yong Jin Kim, Byoung Kwon Lee, Jonathon A. Leipsic, Erica Maffei, Hugo Marques, Pedro de Araújo Gonçalves, Gianluca Pontone, Sanghoon ShinPeter H. Stone, Habib Samady, Renu Virmani, Jagat Narula, Daniel S. Berman, Leslee J. Shaw, Jeroen J. Bax, Fay Y. Lin, James K. Min, Hyuk Jae Chang

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

19 Citations (Scopus)

Abstract

Objectives: This study sought to explore sex-based differences in total and compositional plaque volume (PV) progression. Background: It is unclear whether sex has an impact on PV progression in patients with coronary artery disease (CAD). Methods: The study analyzed a prospective multinational registry of consecutive patients with suspected CAD who underwent 2 or more clinically indicated coronary computed tomography angiography (CTA) at ≥2-year intervals. Total and compositional PV at baseline and follow-up were quantitatively analyzed and normalized using the analyzed total vessel length. Multivariate linear regression models were constructed. Results: Of the 1,255 patients included (median coronary CTA interval 3.8 years), 543 were women and 712 were men. Women were older (62 ± 9 years of age vs. 59 ± 9 years of age; p < 0.001) and had higher total cholesterol levels (195 ± 41 mg/dl vs. 187 ± 39 mg/dl; p = 0.002). Prevalence of hypertension, diabetes, and family history of CAD were not different (all p > 0.05). At baseline, men possessed greater total PV (31.3 mm³ [interquartile range (IQR): 0 to 121.8 mm³] vs. 56.7 mm³ [IQR: 6.8 to 152.1 mm³] p = 0.005), and there was an approximately 9-year delay in women in developing total PV than in men. The prevalence of high-risk plaques was greater in men than women (31% vs. 20%; p < 0.001). In multivariate analysis, after adjusting for age, clinical risk factors, medication use, and total PV at baseline, despite similar total PV progression rates, female sex was associated with greater calcified PV progression (β = 2.83; p = 0.004) but slower noncalcified PV progression (β = –3.39; p = 0.008) and less development of high-risk plaques (β = –0.18; p = 0.049) than in men. Conclusions: The compositional PV progression differed according to sex, suggesting that comprehensive plaque evaluation may contribute to further refining of risk stratification according to sex. (NCT02803411).

Original language	English
Pages (from-to)	2386-2396
Number of pages	11
Journal	JACC: Cardiovascular Imaging
Volume	13
Issue number	11
DOIs	https://doi.org/10.1016/j.jcmg.2020.06.034
Publication status	Published - 2020 Nov

Bibliographical note

Funding Information:
This work was supported by the Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea funded by the Ministry of Science and ICT (Grant No. 2012027176) (to Dr. Chang). The study was also funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging and the Michael Wolk Foundation. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. Dr. Chang had full access to all the data in the study and had final responsibility for the decision to submit the paper for publication. Dr. Min has received funding from the Dalio Foundation, National Institutes of Health, and GE Healthcare; has served on the scientific advisory board of Arineta and GE Healthcare; and owns equity interest in Cleerly. Dr. Samady has served on the scientific advisory board of Philips; owns equity interest in Covanos Inc.; and has received research grant support from Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Khurram Nasir, MD, served as Guest Editor for this paper.

Publisher Copyright:
© 2020 American College of Cardiology Foundation

All Science Journal Classification (ASJC) codes

Radiology Nuclear Medicine and imaging
Cardiology and Cardiovascular Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jcmg.2020.06.034

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Lee, S. E., Sung, J. M., Andreini, D., Al-Mallah, M. H., Budoff, M. J., Cademartiri, F., Chinnaiyan, K., Choi, J. H., Chun, E. J., Conte, E., Gottlieb, I., Hadamitzky, M., Kim, Y. J., Lee, B. K., Leipsic, J. A., Maffei, E., Marques, H., de Araújo Gonçalves, P., Pontone, G., ... Chang, H. J. (2020). Sex Differences in Compositional Plaque Volume Progression in Patients With Coronary Artery Disease. JACC: Cardiovascular Imaging, 13(11), 2386-2396. https://doi.org/10.1016/j.jcmg.2020.06.034

@article{9db35577bd754358a9cf3211c4c71c99,

title = "Sex Differences in Compositional Plaque Volume Progression in Patients With Coronary Artery Disease",

abstract = "Objectives: This study sought to explore sex-based differences in total and compositional plaque volume (PV) progression. Background: It is unclear whether sex has an impact on PV progression in patients with coronary artery disease (CAD). Methods: The study analyzed a prospective multinational registry of consecutive patients with suspected CAD who underwent 2 or more clinically indicated coronary computed tomography angiography (CTA) at ≥2-year intervals. Total and compositional PV at baseline and follow-up were quantitatively analyzed and normalized using the analyzed total vessel length. Multivariate linear regression models were constructed. Results: Of the 1,255 patients included (median coronary CTA interval 3.8 years), 543 were women and 712 were men. Women were older (62 ± 9 years of age vs. 59 ± 9 years of age; p < 0.001) and had higher total cholesterol levels (195 ± 41 mg/dl vs. 187 ± 39 mg/dl; p = 0.002). Prevalence of hypertension, diabetes, and family history of CAD were not different (all p > 0.05). At baseline, men possessed greater total PV (31.3 mm3 [interquartile range (IQR): 0 to 121.8 mm3] vs. 56.7 mm3 [IQR: 6.8 to 152.1 mm3] p = 0.005), and there was an approximately 9-year delay in women in developing total PV than in men. The prevalence of high-risk plaques was greater in men than women (31% vs. 20%; p < 0.001). In multivariate analysis, after adjusting for age, clinical risk factors, medication use, and total PV at baseline, despite similar total PV progression rates, female sex was associated with greater calcified PV progression (β = 2.83; p = 0.004) but slower noncalcified PV progression (β = –3.39; p = 0.008) and less development of high-risk plaques (β = –0.18; p = 0.049) than in men. Conclusions: The compositional PV progression differed according to sex, suggesting that comprehensive plaque evaluation may contribute to further refining of risk stratification according to sex. (NCT02803411).",

author = "Lee, {Sang Eun} and Sung, {Ji Min} and Daniele Andreini and Al-Mallah, {Mouaz H.} and Budoff, {Matthew J.} and Filippo Cademartiri and Kavitha Chinnaiyan and Choi, {Jung Hyun} and Chun, {Eun Ju} and Edoardo Conte and Ilan Gottlieb and Martin Hadamitzky and Kim, {Yong Jin} and Lee, {Byoung Kwon} and Leipsic, {Jonathon A.} and Erica Maffei and Hugo Marques and {de Ara{\'u}jo Gon{\c c}alves}, Pedro and Gianluca Pontone and Sanghoon Shin and Stone, {Peter H.} and Habib Samady and Renu Virmani and Jagat Narula and Berman, {Daniel S.} and Shaw, {Leslee J.} and Bax, {Jeroen J.} and Lin, {Fay Y.} and Min, {James K.} and Chang, {Hyuk Jae}",

note = "Funding Information: This work was supported by the Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea funded by the Ministry of Science and ICT (Grant No. 2012027176) (to Dr. Chang). The study was also funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging and the Michael Wolk Foundation. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. Dr. Chang had full access to all the data in the study and had final responsibility for the decision to submit the paper for publication. Dr. Min has received funding from the Dalio Foundation, National Institutes of Health, and GE Healthcare; has served on the scientific advisory board of Arineta and GE Healthcare; and owns equity interest in Cleerly. Dr. Samady has served on the scientific advisory board of Philips; owns equity interest in Covanos Inc.; and has received research grant support from Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Khurram Nasir, MD, served as Guest Editor for this paper. Publisher Copyright: {\textcopyright} 2020 American College of Cardiology Foundation",

year = "2020",

month = nov,

doi = "10.1016/j.jcmg.2020.06.034",

language = "English",

volume = "13",

pages = "2386--2396",

journal = "JACC: Cardiovascular Imaging",

issn = "1936-878X",

publisher = "Elsevier Inc.",

number = "11",

}

Lee, SE, Sung, JM, Andreini, D, Al-Mallah, MH, Budoff, MJ, Cademartiri, F, Chinnaiyan, K, Choi, JH, Chun, EJ, Conte, E, Gottlieb, I, Hadamitzky, M, Kim, YJ, Lee, BK, Leipsic, JA, Maffei, E, Marques, H, de Araújo Gonçalves, P, Pontone, G, Shin, S, Stone, PH, Samady, H, Virmani, R, Narula, J, Berman, DS, Shaw, LJ, Bax, JJ, Lin, FY, Min, JK & Chang, HJ 2020, 'Sex Differences in Compositional Plaque Volume Progression in Patients With Coronary Artery Disease', JACC: Cardiovascular Imaging, vol. 13, no. 11, pp. 2386-2396. https://doi.org/10.1016/j.jcmg.2020.06.034

TY - JOUR

T1 - Sex Differences in Compositional Plaque Volume Progression in Patients With Coronary Artery Disease

AU - Lee, Sang Eun

AU - Sung, Ji Min

AU - Andreini, Daniele

AU - Al-Mallah, Mouaz H.

AU - Budoff, Matthew J.

AU - Cademartiri, Filippo

AU - Chinnaiyan, Kavitha

AU - Choi, Jung Hyun

AU - Chun, Eun Ju

AU - Conte, Edoardo

AU - Gottlieb, Ilan

AU - Hadamitzky, Martin

AU - Kim, Yong Jin

AU - Lee, Byoung Kwon

AU - Leipsic, Jonathon A.

AU - Maffei, Erica

AU - Marques, Hugo

AU - de Araújo Gonçalves, Pedro

AU - Pontone, Gianluca

AU - Shin, Sanghoon

AU - Stone, Peter H.

AU - Samady, Habib

AU - Virmani, Renu

AU - Narula, Jagat

AU - Berman, Daniel S.

AU - Shaw, Leslee J.

AU - Bax, Jeroen J.

AU - Lin, Fay Y.

AU - Min, James K.

AU - Chang, Hyuk Jae

N1 - Funding Information: This work was supported by the Leading Foreign Research Institute Recruitment Program through the National Research Foundation of Korea funded by the Ministry of Science and ICT (Grant No. 2012027176) (to Dr. Chang). The study was also funded in part by a generous gift from the Dalio Institute of Cardiovascular Imaging and the Michael Wolk Foundation. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. Dr. Chang had full access to all the data in the study and had final responsibility for the decision to submit the paper for publication. Dr. Min has received funding from the Dalio Foundation, National Institutes of Health, and GE Healthcare; has served on the scientific advisory board of Arineta and GE Healthcare; and owns equity interest in Cleerly. Dr. Samady has served on the scientific advisory board of Philips; owns equity interest in Covanos Inc.; and has received research grant support from Medtronic. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Khurram Nasir, MD, served as Guest Editor for this paper. Publisher Copyright: © 2020 American College of Cardiology Foundation

PY - 2020/11

Y1 - 2020/11

N2 - Objectives: This study sought to explore sex-based differences in total and compositional plaque volume (PV) progression. Background: It is unclear whether sex has an impact on PV progression in patients with coronary artery disease (CAD). Methods: The study analyzed a prospective multinational registry of consecutive patients with suspected CAD who underwent 2 or more clinically indicated coronary computed tomography angiography (CTA) at ≥2-year intervals. Total and compositional PV at baseline and follow-up were quantitatively analyzed and normalized using the analyzed total vessel length. Multivariate linear regression models were constructed. Results: Of the 1,255 patients included (median coronary CTA interval 3.8 years), 543 were women and 712 were men. Women were older (62 ± 9 years of age vs. 59 ± 9 years of age; p < 0.001) and had higher total cholesterol levels (195 ± 41 mg/dl vs. 187 ± 39 mg/dl; p = 0.002). Prevalence of hypertension, diabetes, and family history of CAD were not different (all p > 0.05). At baseline, men possessed greater total PV (31.3 mm3 [interquartile range (IQR): 0 to 121.8 mm3] vs. 56.7 mm3 [IQR: 6.8 to 152.1 mm3] p = 0.005), and there was an approximately 9-year delay in women in developing total PV than in men. The prevalence of high-risk plaques was greater in men than women (31% vs. 20%; p < 0.001). In multivariate analysis, after adjusting for age, clinical risk factors, medication use, and total PV at baseline, despite similar total PV progression rates, female sex was associated with greater calcified PV progression (β = 2.83; p = 0.004) but slower noncalcified PV progression (β = –3.39; p = 0.008) and less development of high-risk plaques (β = –0.18; p = 0.049) than in men. Conclusions: The compositional PV progression differed according to sex, suggesting that comprehensive plaque evaluation may contribute to further refining of risk stratification according to sex. (NCT02803411).

AB - Objectives: This study sought to explore sex-based differences in total and compositional plaque volume (PV) progression. Background: It is unclear whether sex has an impact on PV progression in patients with coronary artery disease (CAD). Methods: The study analyzed a prospective multinational registry of consecutive patients with suspected CAD who underwent 2 or more clinically indicated coronary computed tomography angiography (CTA) at ≥2-year intervals. Total and compositional PV at baseline and follow-up were quantitatively analyzed and normalized using the analyzed total vessel length. Multivariate linear regression models were constructed. Results: Of the 1,255 patients included (median coronary CTA interval 3.8 years), 543 were women and 712 were men. Women were older (62 ± 9 years of age vs. 59 ± 9 years of age; p < 0.001) and had higher total cholesterol levels (195 ± 41 mg/dl vs. 187 ± 39 mg/dl; p = 0.002). Prevalence of hypertension, diabetes, and family history of CAD were not different (all p > 0.05). At baseline, men possessed greater total PV (31.3 mm3 [interquartile range (IQR): 0 to 121.8 mm3] vs. 56.7 mm3 [IQR: 6.8 to 152.1 mm3] p = 0.005), and there was an approximately 9-year delay in women in developing total PV than in men. The prevalence of high-risk plaques was greater in men than women (31% vs. 20%; p < 0.001). In multivariate analysis, after adjusting for age, clinical risk factors, medication use, and total PV at baseline, despite similar total PV progression rates, female sex was associated with greater calcified PV progression (β = 2.83; p = 0.004) but slower noncalcified PV progression (β = –3.39; p = 0.008) and less development of high-risk plaques (β = –0.18; p = 0.049) than in men. Conclusions: The compositional PV progression differed according to sex, suggesting that comprehensive plaque evaluation may contribute to further refining of risk stratification according to sex. (NCT02803411).

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Sex Differences in Compositional Plaque Volume Progression in Patients With Coronary Artery Disease

Abstract

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UN SDGs

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