Heart Attack Risk Differs Between Men and Women

According to a new study on coronary CT angiography (CTA), a noninvasive test to assess the coronary arteries for blockages, coronary artery disease, which is caused by a build-up of fat and other substances that form plaque on vessel walls, is different for men and women.

Researchers at the Medical University of South Carolina analyzed the results of coronary CTA on 480 patients. Approximately 65 percent 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, MD was quoted saying.

By comparing the coronary CTA results with outcome data over a 12.8-month follow-up period, the researchers were able to compare 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," Dr. Nance was quoted saying.

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.

"This research tells us that extensive coronary plaque is more worrisome in women than the equivalent amount in men," Dr. Nance was quoted saying.

However, when analyzing risk factors associated with the presence of individual types of plaque, the risk for major adverse cardiac events was greater in men, compared to women, when their artery segments contained non-calcified plaque.

CTA provides excellent prognostic information that helps identify risk; however gender differences still need to be considered.

Source: Radiological Society of North America, December 2011