Evidence map›Paper›PMID 36670043›Full record

ArticleJournal of cardiovascular computed tomography

Sex differences in computed tomography angiography-derived coronary plaque burden in relation to invasive fractional flow reserve.

Donghee Han, Pepijn van Diemen, Keiichiro Kuronuma, Andrew Lin, Manish Motwani, Priscilla McElhinney, Guadalupe Flores Tomasino, Caroline Park, Alan Kwan, Evangelos Tzolos and 11 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of cardiovascular computed tomography. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. The Role of Cardiac Computed Tomography Angiography in Risk Stratification for Coronary Artery Disease.Journal of the Society for Cardiovascular Angiography & Interventions · 2024
    Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 5 institutions in 3 countries.

Donghee HanDepartment of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: Donghee.han@cshs.org.
Pepijn van DiemenDepartment of Cardiology, VU University Medical Center, Amsterdam, the Netherlands.
Keiichiro KuronumaDepartment of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Andrew LinBiomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Manish MotwaniManchester Heart Centre, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
Priscilla McElhinneyBiomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Guadalupe Flores TomasinoBiomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Caroline ParkBiomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Alan KwanDepartment of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Evangelos TzolosDepartment of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, United Kingdom.
Eyal KleinDepartment of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Kajetan GrodeckiBiomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Benjamin ShouBiomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Balaji TamarappooDepartment of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Cardiovascular Institute, Indiana University School of Medicine, Indianapolis, IN, United States.
Sebastien CadetDepartment of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Ibrahim DanadDepartment of Cardiology, VU University Medical Center, Amsterdam, the Netherlands.
Roel S DriessenDepartment of Cardiology, VU University Medical Center, Amsterdam, the Netherlands.
Daniel S BermanDepartment of Imaging and Medicine and the Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Piotr J SlomkaArtificial Interlligence in Medicine Program, Cedars-Sinai Medical Center, Los Angeles, CA, United States.
Damini DeyBiomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Paul KnaapenDepartment of Cardiology, VU University Medical Center, Amsterdam, the Netherlands.
Cedars-Sinai Medical Center · USAmsterdam UMC Location Vrije Universiteit Amsterdam · NLCedars-Sinai Smidt Heart Institute · USBritish Heart Foundation · GBManchester University NHS Foundation Trust · GB

Funding

Integrated prediction of cardiovascular events by automated coronary plaque and pericoronary adipose tissue quantification from CT AngiographyR01HL148787 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI DEY, DAMINI · 2020 to 2023
$3.0M
Effect of Intensive Medical Treatment on Quantified Coronary Artery Plaque Components with Serial Coronary CTA in Women with Non-Obstructive CADR01HL151266 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI DEY, DAMINI, TAMARAPPOO, BALAJI K. · 2020 to 2023
$1.6M
NHLBI NIH HHS R01 HL148787NHLBI NIH HHS R01 HL151266
6 · The paper itself

Abstract

backgroundDistinct sex-related differences exist in coronary artery plaque burden and distribution. We aimed to explore sex differences in quantitative plaque burden by coronary CT angiography (CCTA) in relation to ischemia by invasive fractional flow reserve (FFR).

methodsThis post-hoc analysis of the PACIFIC trial included 581 vessels in 203 patients (mean age 58.1 ​± ​8.7 years, 63.5% male) who underwent CCTA and per-vessel invasive FFR. Quantitative assessment of total, calcified, non-calcified, and low-density non-calcified plaque burden were performed using semiautomated software. Significant ischemia was defined as invasive FFR ≤0.8.

resultsThe per-vessel frequency of ischemia was higher in men than women (33.5% vs. 7.5%, p ​< ​0.001). Women had a smaller burden of all plaque subtypes (all p ​< ​0.01). There was no sex difference on total, calcified, or non-calcified plaque burdens in vessels with ischemia; only low-density non-calcified plaque burden was significantly lower in women (beta: -0.183, p ​= ​0.035). The burdens of all plaque subtypes were independently associated with ischemia in both men and women (For total plaque burden (5% increase): Men, OR: 1.15, 95%CI: 1.06-1.24, p ​= ​0.001; Women, OR: 1.96, 95%CI: 1.11-3.46, p ​= ​0.02). No significant interaction existed between sex and total plaque burden for predicting ischemia (interaction p ​= ​0.108). The addition of quantitative plaque burdens to stenosis severity and adverse plaque characteristics improved the discrimination of ischemia in both men and women.

conclusionsIn symptomatic patients with suspected CAD, women have a lower CCTA-derived burden of all plaque subtypes compared to men. Quantitative plaque burden provides independent and incremental predictive value for ischemia, irrespective of sex.

Indexed as

Coronary Artery DiseaseCoronary StenosisFractional Flow Reserve, MyocardialPlaque, AtheroscleroticAgedComputed Tomography AngiographyCoronary AngiographyFemaleHumansMaleMiddle AgedPredictive Value of TestsSeverity of Illness IndexComputed tomographyFractional flow reserveQuantitative plaque analysisSex difference

Identifiers

PMID36670043
PMCPMC10148895
OpenAlexW4317685061

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.