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Men, women with mild CAD have similar outlooks, study finds

Wednesday December 4, 2013
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An analysis of data from an international multicenter study of coronary computed tomography angiography reveals that men and women with mild coronary artery disease and similar cardiovascular risk profiles share similar prognoses.

“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,” Jonathon Leipsic, MD, FRCPC, director of medical imaging at St. Paul’s Hospital in Vancouver, said in a news release.

“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.”

For the study, which was presented Dec. 3 in Chicago at the annual meeting of the Radiological Society of North America, Leipsic and colleagues used data on 27,725 individuals in six countries who underwent coronary computed tomography angiography. The registry also included participants’ traditional risk factors, allowing for the derivation of Framingham scores, which are used to determine an individual’s risk of developing cardiovascular disease.

From the registry, the researchers identified 18,158 patients who did not have known coronary artery disease and whose CCTA results were normal or indicated nonobstructive disease (meaning coronary arteries were less than 50% blocked). These patients, including 8,808 women and 9,350 men, then were matched on the basis of pre-existing cardiovascular risk factors and the extent of their coronary artery disease as determined by CCTA, resulting in a one-to-one cohort of 11,462 patients.

A statistical analysis of the matched cohort revealed that, controlling for all cardiovascular risk factors, nonobstructive coronary artery disease conferred a similar adverse risk of death or myocardial infarction in both men and women. Conversely, the absence of plaque on CCTA conferred a good prognosis for both men and women.

Of the patients in the cohort, only 251 experienced a MI or cardiac-related death during an average follow-up period of 2.3 years.

“This analysis is exciting because this has never been shown before,” Leipsic said. “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.”

Conference information: www.rsna.org/Annual_Meeting.aspx


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