Observational studyJACC. Cardiovascular imaging2016
Sex-Specific Associations Between Coronary Artery Plaque Extent and Risk of Major Adverse Cardiovascular Events: The CONFIRM Long-Term Registry.
Observational study in JACC. Cardiovascular imaging, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
56 citing papers in PubMed, 125 citations in OpenAlex.
- Sex-Specific Computed Tomography Coronary Plaque Characterization and Risk of Myocardial Infarction.JACC. Cardiovascular imaging · 2021Trial
- Whole heart atherosclerosis volume and risk for major adverse cardiovascular events across the clinical likelihood for obstructive CAD; the CONFIRM2 study.American journal of preventive cardiology · 2027Article
- Differences of plaque burden measures on CCTA in younger men and women.American journal of preventive cardiology · 2026Article
- Subclinical Atherosclerosis, Hyperlipidemia and New-Onset Diabetes Should Not Be Ignored Despite Initial Angiographic Exclusion of Significant Atherosclerotic Occlusive Arterial Disease.Diagnostics (Basel, Switzerland) · 2026Article
- Coronary Computed Tomography and Artificial Intelligence-based Plaque Analysis.Current atherosclerosis reports · 2026Review
- Design and rationale of the WARRIOR ancillary study for coronary CT angiographic analysis.American heart journal · 2026Article
- Immune Checkpoint Inhibitors, Atherosclerotic Cardiovascular Events, and Plaque Progression Among Women With Cancer.Journal of the American Heart Association · 2026Article
- Prognostic value of non-obstructive coronary artery disease based on coronary computed tomography angiography in a long-term follow-up and multicenter study.Scientific reports · 2025Observational
- QUIET WARRIOR - Rationale and design: An ancillary study to the Women's IschemiA TRial to Reduce Events in Nonobstructive CAD (WARRIOR).American heart journal plus : cardiology research and practice · 2025Article
- Sex-Based Differences and Outcomes in Unselected Patients Undergoing Coronary Angiography.Journal of clinical medicine · 2025Article
- The Role of Cardiac Computed Tomography Angiography in Risk Stratification for Coronary Artery Disease.Journal of the Society for Cardiovascular Angiography & Interventions · 2024Review
- Atherosclerosis evaluation and cardiovascular risk estimation using coronary computed tomography angiography.European heart journal · 2024Review
- Prognostic value of combined coronary CT angiography and myocardial perfusion imaging in women and men.European heart journal. Cardiovascular Imaging · 2023Article
- Atherosclerosis Burden of Brain- and Heart-Supplying Arteries and the Relationship With Vascular Risk in Patients With Ischemic Stroke.Journal of the American Heart Association · 2023Article
- Improved Performance of PET Myocardial Perfusion Imaging Compared to SPECT in the Evaluation of Suspected CAD.Current cardiology reports · 2023Review
- Effect of nonobstructive coronary stenosis on coronary microvascular dysfunction and long-term outcomes in patients with INOCA.Clinical cardiology · 2023Article
- Vessel and sex differences in pericoronary adipose tissue attenuation obtained with coronary CT in individuals without coronary atherosclerosis.The international journal of cardiovascular imaging · 2022Article
- Unsupervised machine learning based on clinical factors for the detection of coronary artery atherosclerosis in type 2 diabetes mellitus.Cardiovascular diabetology · 2022Article
- Cardiovascular Imaging for Ischemic Heart Disease in Women: Time for a Paradigm Shift.JACC. Cardiovascular imaging · 2022Review
- The Prognostic Value of Cardiac Troponin I in Patients with or without Three-Vessel Disease Undergoing Complete Percutaneous Coronary Intervention.Journal of clinical medicine · 2022Article
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Authors and funding
29 authors at 17 institutions in 10 countries.
Funding
Abstract
objectivesThe purpose of this study was to examine sex-specific associations, if any, between per-vessel coronary artery disease (CAD) extent and the risk of major adverse cardiovascular events (MACE) over a 5-year study duration.
backgroundThe presence and extent of CAD diagnosed by coronary computed tomography angiography (CTA) is associated with increased short-term mortality and MACE. Nevertheless, some uncertainty remains regarding the influence of sex on these findings.
methods5,632 patients (mean age 60.2 ± 11.8 years, 36.5% women) from the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International Multicenter) registry were followed for 5 years. Obstructive CAD was defined as ≥50% luminal stenosis in a coronary vessel. Using Cox proportional hazards models, we calculated the hazard ratio (HR) for incident MACE among women and men, defined as death or myocardial infarction.
resultsObstructive CAD was more prevalent in men (42% vs. 26%; p < 0.001), whereas women were more likely to have normal coronary arteries (43% vs. 27%; p < 0.001). There were a total of 798 incident MACE events. After adjustment, there was a strong association between increased MACE risk and nonobstructive CAD (HR: 2.16 for women, 2.56 for men; p < 0.001 for both), obstructive 1-vessel CAD (HR: 3.69 and 2.66; p < 0.001), 2-vessel CAD (HR: 3.92 and 3.55; p < 0.001), and 3-vessel/left main CAD (HR: 5.94 and 4.44; p < 0.001). Further exploratory analyses of atherosclerotic burden did not identify sex-specific patterns predictive of MACE.
conclusionsIn a large prospective coronary CTA cohort followed long-term, we did not observe an interaction of sex for the association between MACE risk and increased per-vessel extent of obstructive CAD. These findings highlight the persistent prognostic significance of anatomic CAD subsets as detected by coronary CTA for the risk of MACE in both women and men.
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