ArticleOpen heart2025
Age-stratified differences in coronary artery plaque phenotypes in women and men with non-obstructive coronary artery disease.
Article in Open heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04009421 (Covariates of Coronary Artery Plaque Burden and Composition by CT Coronary Angiography in Women and Men With Stable Angina and Non-obstructive Coronary Artery Disease - Analysis From the NORIC Registry), which is not on this map. Cited by 3 papers.
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Covariates of Coronary Artery Plaque Burden and Composition by CT Coronary Angiography in Women and Men With Stable Angina and Non-obstructive Coronary Artery Disease - Analysis From the NORIC Registry
Who cites it
3 citing papers in PubMed.
- Risk in Women Emerges at Lower Coronary Plaque Burden Than in Men: PROMISE Trial.Circulation. Cardiovascular imaging · 2026Article
- From plaque to event: coronary plaque burden and morphology in predicting adverse cardiovascular outcomes.Frontiers in cardiovascular medicine · 2026Article
- Curcumin in Inflammatory Complications: Therapeutic Applications and Clinical Evidence.International journal of molecular sciences · 2025Review
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCoronary artery disease (CAD) progression and risk of cardiac events differ between women and men during the lifespan. Accordingly, we aimed to explore the impact of sex and age on plaque phenotype in non-obstructive CAD.
methodWe included 1189 patients with non-obstructive CAD (48% women) from the Norwegian Registry of Invasive Cardiology and quantitatively assessed each patient's plaque phenotype by coronary CT angiography. Plaque subtypes included calcified (>350 Hounsfield units [HU]), fibrous (131 to 350 HU), fibrofatty (76 to 130 HU) and necrotic core plaques (-30 to 75 HU). The impact of sex on plaque phenotype was assessed after age stratification (≤50, 51-64 and ≥65 years).
resultsTotal plaque burden adjusted for vessel volume was higher in middle-aged and older women compared with men (all p<0.05). Women had lower proportions of fibrofatty plaques compared with men across all age groups, while middle-aged and older women had higher proportions of calcified and fibrous plaques compared with men. Middle-aged and older men had higher proportions of necrotic core plaques compared with women (all p<0.05). After adjusting for cardiovascular risk factors, female sex remained independently associated with total plaque burden (β=1.0 [0.5 to 1.5], p<0.001), and younger age and male sex with fibrofatty plaque burden (β=-2.8 [-4.4 to -1.2], p<0.001, and β=-3.8 [-4.9 to -2.8], p<0.001, respectively).
conclusionIn non-obstructive CAD, female sex was associated with a higher total plaque burden, whereas male sex and younger age were associated with a higher proportion of vulnerable fibrofatty plaques. Our results highlight important sex differences in plaque phenotypes among patients with non-obstructive CAD during the lifespan, which may impact risk-stratification. TRIAL REGISTRATION NUMBER: NCT04009421.
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