ArticleNetherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation2019
Sex differences in coronary artery plaque composition detected by coronary computed tomography: quantitative and qualitative analysis.
Article in Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Atherosclerosis after pre-eclampsia: systematic review and meta-analysis.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2026Pooled it
- Higher exercise capacity, but not omega-3 fatty acid consumption, predicts lower coronary artery calcium scores in women and men with coronary artery disease.Atherosclerosis · 2023Trial
- Sex-Specific Computed Tomography Coronary Plaque Characterization and Risk of Myocardial Infarction.JACC. Cardiovascular imaging · 2021Trial
- Optimizing coronary CT angiography in patients with delayed contrast arrival using a free-breathing, high-threshold bolus-tracking protocol.Insights into imaging · 2026Article
- Multimodality Imaging to Determine Underlying Causes of Myocardial Infarction With Nonobstructive Coronary Arteries in Women and Men.Circulation · 2026Article
- Female-Biased VSMC GRNs Predict MYH9 as Regulator of Fibrous Plaque Phenotype.Circulation research · 2026Article
- Risk in Women Emerges at Lower Coronary Plaque Burden Than in Men: PROMISE Trial.Circulation. Cardiovascular imaging · 2026Article
- Lipoprotein(a) and plaque progression: insights from serial coronary computed tomography angiography and quantitative plaque assessment.Frontiers in cardiovascular medicine · 2026Article
- Sex Differences in Atherosclerotic Coronary Artery Disease Patterns.Journal of the American Heart Association · 2025Article
- Antisense Oligonucleotide Targeting Sortilin Reduces Vascular Calcification in Mice in a Sex-Dependent Manner.Arteriosclerosis, thrombosis, and vascular biology · 2025Article
- Age-stratified differences in coronary artery plaque phenotypes in women and men with non-obstructive coronary artery disease.Open heart · 2025Article
- AI-Quantitative CT Coronary Plaque Features Associate With a Higher Relative Risk in Women: CONFIRM2 Registry.Circulation. Cardiovascular imaging · 2025Observational
- Sex differences in features of atherosclerotic plaques as revealed by various imaging techniques: historical review.Frontiers in physiology · 2025Review
- Disparities in chronic ischemic heart disease-related mortality across sex, race, and urbanization status in the United States, 1999-2019.PLOS global public health · 2025Article
- Extracranial carotid plaque calcification and its association with risk factors for cerebrovascular events: insights from the ANTIQUE study.Frontiers in neurology · 2025Article
- Is Preventative Oophorectomy Safe?: Providing Reassurance to Young Women at Risk.JACC. CardioOncology · 2024Article
- Article
- Sex and age-specific interactions of coronary atherosclerotic plaque onset and prognosis from coronary computed tomography.European heart journal. Cardiovascular Imaging · 2023Article
- Advanced Cardiac Imaging and Women's Chest Pain: A Question of Gender.Diagnostics (Basel, Switzerland) · 2023Review
- Cardiovascular risk factors and pericardial fat volume as predictors of coronary atherosclerosis burden in postmenopausal women: A retrospective, single center study.Health science reports · 2023Article
Corrections and comments
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5 authors.
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Abstract
backgroundSex differences in the calculation of coronary heart disease risk have been analysed extensively. However, data on coronary plaque morphology diverge. We analysed plaque characteristics in patients with suspected coronary artery disease (CAD) and defined prognostic factors using coronary computed tomography angiography (CCTA).
methodsA total of 6,050 consecutive patients underwent CCTA and were enrolled in the registry. Patients with known CAD were excluded. The patients were propensity score matched (1:1 male:female) for age and known coronary risk factors. Coronary arteries were evaluated for stenosis, plaque types (non-calcified, mixed and calcified) and high-risk plaque features (napkin-ring sign, low-attenuation plaque, spotty calcifications, positive remodelling). Clinical follow-up was performed.
resultsA total of 1,050 patients (525 female, 525 male) in matched cohorts were selected for analysis. CCTA showed significantly higher calcium scores for males (mean 180.5 vs 67.8 AU, p < 0.0001) and a higher rate of CAD (66.0% vs 34.1%, p < 0.0001). In a total of 16,800 segments, males had significantly more plaques (861 vs 752, p < 0.0001) with a significantly larger proportion of calcified plaques, while females had more mixed and non-calcified plaques (33.5% vs 24.4%, p = 0.006 and 24.1% vs 13.6%, p = 0.22, respectively). After a mean follow-up of 5.6 years, major adverse cardiac event (MACE) rate was 5.3% in male and 1.9% in female patients (p < 0.05). The relative odds ratio for high-risk plaque features to predict MACE was higher in females.
conclusionBased on a higher relative risk for women with high-risk plaque features, the findings of our study support the increased importance of a differentiated qualitative plaque analysis to improve the risk stratification for both sexes.
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