ArticleEuropean heart journal. Cardiovascular Imaging2023
Sex and age-specific interactions of coronary atherosclerotic plaque onset and prognosis from coronary computed tomography.
Article in European heart journal. Cardiovascular Imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Global, regional, and national burden of cardiovascular diseases among postmenopausal women, 1990-2040: a systematic analysis for the global burden of disease study 2021.Journal of advanced research · 2026Pooled it
- Differences of plaque burden measures on CCTA in younger men and women.American journal of preventive cardiology · 2026Article
- Time-Critical Cardiovascular Risk After COVID-19: A Population-Based Analysis Across Variant Eras.Mayo Clinic proceedings. Innovations, quality & outcomes · 2026Article
- Article
- Risk in Women Emerges at Lower Coronary Plaque Burden Than in Men: PROMISE Trial.Circulation. Cardiovascular imaging · 2026Article
- Sex-specific cardiovascular risk prediction using AI-derived epicardial adipose tissue measurements on CT calcium scoring exams.American journal of preventive cardiology · 2026Article
- The influence of high exercise levels on the coronary atherosclerosis profile by computed tomography angiography and outcomes.American journal of preventive cardiology · 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
- Imaging approaches in risk stratification of patients with coronary artery disease: a narrative review.Archives of medical science : AMS · 2025Article
- The Role of Cardiac Computed Tomography Angiography in Risk Stratification for Coronary Artery Disease.Journal of the Society for Cardiovascular Angiography & Interventions · 2024Review
- The Clear Value of Coronary Artery Calcification Evaluation on Non-Gated Chest Computed Tomography for Cardiac Risk Stratification.Cardiology and therapy · 2024Review
- Cardiovascular imaging research and innovation in 2023.European heart journal. Imaging methods and practice · 2024Review
- Spectrum of Ischemic Heart Disease Throughout a Woman's Life Cycle.Methodist DeBakey cardiovascular journal · 2024Review
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
31 authors at 20 institutions in 10 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThe totality of atherosclerotic plaque derived from coronary computed tomography angiography (CCTA) emerges as a comprehensive measure to assess the intensity of medical treatment that patients need. This study examines the differences in age onset and prognostic significance of atherosclerotic plaque burden between sexes. METHODS AND
resultsFrom a large multi-center CCTA registry the Leiden CCTA score was calculated in 24 950 individuals. A total of 11 678 women (58.5 ± 12.4 years) and 13 272 men (55.6 ± 12.5 years) were followed for 3.7 years for major adverse cardiovascular events (MACE) (death or myocardial infarction). The age where the median risk score was above zero was 12 years higher in women vs. men (64-68 years vs. 52-56 years, respectively, P < 0.001). The Leiden CCTA risk score was independently associated with MACE: score 6-20: HR 2.29 (1.69-3.10); score > 20: HR 6.71 (4.36-10.32) in women, and score 6-20: HR 1.64 (1.29-2.08); score > 20: HR 2.38 (1.73-3.29) in men. The risk was significantly higher for women within the highest score group (adjusted P-interaction = 0.003). In pre-menopausal women, the risk score was equally predictive and comparable with men. In post-menopausal women, the prognostic value was higher for women [score 6-20: HR 2.21 (1.57-3.11); score > 20: HR 6.11 (3.84-9.70) in women; score 6-20: HR 1.57 (1.19-2.09); score > 20: HR 2.25 (1.58-3.22) in men], with a significant interaction for the highest risk group (adjusted P-interaction = 0.004).
conclusionWomen developed coronary atherosclerosis approximately 12 years later than men. Post-menopausal women within the highest atherosclerotic burden group were at significantly higher risk for MACE than their male counterparts, which may have implications for the medical treatment intensity.
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