TY - JOUR
T1 - Relation of Gender to Atherosclerotic Plaque Characteristics by Differing Angiographic Stenosis Severity
AU - Jonas, Rebecca
AU - Patel, Toral
AU - Crabtree, Tami R.
AU - Jennings, Robert S.
AU - Heo, Ran
AU - Park, Hyung-Bok
AU - Marques, Hugo
AU - Chang, Hyuk-Jae
AU - Stuijfzand, Wijnand J.
AU - van Rosendael, Alexander R.
AU - Choi, Jung Hyun
AU - Doh, Joon-Hyung
AU - Her, Ae-Young
AU - Koo, Bon-Kwon
AU - Nam, Chang-Wook
AU - Shin, Sang-Hoon
AU - Cole, Jason
AU - Gimelli, Alessia
AU - Khan, Muhammad Akram
AU - Lu, Bin
AU - Gao, Yang
AU - Nabi, Faisal
AU - Al-Mallah, Mouaz H.
AU - Nakazato, Ryo
AU - Schoepf, U. Joseph
AU - Driessen, Roel S.
AU - Bom, Michiel J.
AU - Thompson, Randall C.
AU - Jang, James J.
AU - Ridner, Michael
AU - Rowan, Chris
AU - Avelar, Erick
AU - Généreux, Philippe
AU - Knaapen, Paul
AU - de Waard, Guus A.
AU - Pontone, Gianluca
AU - Andreini, Daniele
AU - Bax, Jeroen J.
AU - Choi, Andrew D.
AU - Earls, James P.
AU - Hoffmann, Udo
AU - Min, James K.
AU - Villines, Todd C.
N1 - Publisher Copyright: © 2023 The Authors
PY - 2023/10/1
Y1 - 2023/10/1
N2 - It is unknown whether gender influences the atherosclerotic plaque characteristics (APCs) of lesions of varying angiographic stenosis severity. This study evaluated the imaging data of 303 symptomatic patients from the derivation arm of the CREDENCE (Computed TomogRaphic Evaluation of Atherosclerotic Determinants of Myocardial IsChEmia) trial, all of whom underwent coronary computed tomographic angiography and clinically indicated nonemergent invasive coronary angiography upon study enrollment. Index tests were interpreted by 2 blinded core laboratories, one of which performed quantitative coronary computed tomographic angiography using an artificial intelligence application to characterize and quantify APCs, including percent atheroma volume (PAV), low-density noncalcified plaque (LD-NCP), noncalcified plaque (NCP), calcified plaque (CP), lesion length, positive arterial remodeling, and high-risk plaque (a combination of LD-NCP and positive remodeling ≥1.10); the other classified lesions as obstructive (≥50% diameter stenosis) or nonobstructive (<50% diameter stenosis) based on quantitative invasive coronary angiography. The relation between APCs and angiographic stenosis was further examined by gender. The mean age of the study cohort was 64.4 ± 10.2 years (29.0% female). In patients with obstructive disease, men had more LD-NCP PAV (0.5 ± 0.4 vs 0.3 ± 0.8, p = 0.03) and women had more CP PAV (11.7 ± 1.6 vs 8.0 ± 0.8, p = 0.04). Obstructive lesions had more NCP PAV compared with their nonobstructive lesions in both genders, however, obstructive lesions in women also demonstrated greater LD-NCP PAV (0.4 ± 0.5 vs 1.0 ± 1.8, p = 0.03), and CP PAV (17.4 ± 16.5 vs 25.9 ± 18.7, p = 0.03) than nonobstructive lesions. Comparing the composition of obstructive lesions by gender, women had more CP PAV (26.3 ± 3.4 vs 15.8 ± 1.5, p = 0.005) whereas men had more NCP PAV (33.0 ± 1.6 vs 26.7 ± 2.5, p = 0.04). Men had more LD-NCP PAV in nonobstructive lesions compared with women (1.2 ± 0.2 vs 0.6 ± 0.2, p = 0.02). In conclusion, there are gender-specific differences in plaque composition based on stenosis severity.
AB - It is unknown whether gender influences the atherosclerotic plaque characteristics (APCs) of lesions of varying angiographic stenosis severity. This study evaluated the imaging data of 303 symptomatic patients from the derivation arm of the CREDENCE (Computed TomogRaphic Evaluation of Atherosclerotic Determinants of Myocardial IsChEmia) trial, all of whom underwent coronary computed tomographic angiography and clinically indicated nonemergent invasive coronary angiography upon study enrollment. Index tests were interpreted by 2 blinded core laboratories, one of which performed quantitative coronary computed tomographic angiography using an artificial intelligence application to characterize and quantify APCs, including percent atheroma volume (PAV), low-density noncalcified plaque (LD-NCP), noncalcified plaque (NCP), calcified plaque (CP), lesion length, positive arterial remodeling, and high-risk plaque (a combination of LD-NCP and positive remodeling ≥1.10); the other classified lesions as obstructive (≥50% diameter stenosis) or nonobstructive (<50% diameter stenosis) based on quantitative invasive coronary angiography. The relation between APCs and angiographic stenosis was further examined by gender. The mean age of the study cohort was 64.4 ± 10.2 years (29.0% female). In patients with obstructive disease, men had more LD-NCP PAV (0.5 ± 0.4 vs 0.3 ± 0.8, p = 0.03) and women had more CP PAV (11.7 ± 1.6 vs 8.0 ± 0.8, p = 0.04). Obstructive lesions had more NCP PAV compared with their nonobstructive lesions in both genders, however, obstructive lesions in women also demonstrated greater LD-NCP PAV (0.4 ± 0.5 vs 1.0 ± 1.8, p = 0.03), and CP PAV (17.4 ± 16.5 vs 25.9 ± 18.7, p = 0.03) than nonobstructive lesions. Comparing the composition of obstructive lesions by gender, women had more CP PAV (26.3 ± 3.4 vs 15.8 ± 1.5, p = 0.005) whereas men had more NCP PAV (33.0 ± 1.6 vs 26.7 ± 2.5, p = 0.04). Men had more LD-NCP PAV in nonobstructive lesions compared with women (1.2 ± 0.2 vs 0.6 ± 0.2, p = 0.02). In conclusion, there are gender-specific differences in plaque composition based on stenosis severity.
UR - http://www.scopus.com/inward/record.url?scp=85167417592&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.amjcard.2023.07.004
DO - https://doi.org/10.1016/j.amjcard.2023.07.004
M3 - Article
C2 - 37562193
SN - 0002-9149
VL - 204
SP - 276
EP - 283
JO - American Journal of Cardiology
JF - American Journal of Cardiology
ER -