Abstract 11067: Coronary Vascular Dysfunction, Vulnerable Plaque Composition and Response to Statin Therapy: The role of Sex
Background: Despite gender blind recommendations for treatment of atherosclerosis, significant gender differences in treatment exist in such patients. This study evaluates the sex-specific differences in coronary vascular function, vulnerable plaque composition and response to statin therapy.
Methods: Two hundred and forty eight subjects (aged 65±8 years, 46% women, 100% statin therapy) underwent computed tomography angiography (CTA) and were prospectively followed. CDI in left anterior descending artery (LAD) was defined as: [(Early_diastole - mid_diastole lumen cross section area(CSA))/ (lumen CSA in mid_diastole x central pulse pressure) x1000]. Vulnerable plaque composite score(VPS) was measured using semi-quantified plaque volume (none, localized, intermediate, or diffuse) and severity of diseased coronaries (normal, mild, moderate, or severe) in non-calcified and mixed plaques based on American Heart Association 15-segment model. Response to statin therapy was defined based on CDI (CDI>2.94 responders vs. CDI<2.94 non-responders) and vulnerable plaque score (VPS>0, non-responders vs. VPS=0, responders).
Results: There was no significant difference in age between genders. CDI was significantly higher in women as compared to men (P<0.01). Vulnerable plaque score was significantly lower in women than men (P<0.01). After adjustment for cardiovascular risk factors using logistic regression analysis, the risk of impaired CDI was 50% higher in women as compared to men. Similarly, the risk of vulnerable plaque was 17% higher in women as compared to men. The likelihood of response to statin therapy (CDI>2.94 and VPS=0) was 127% higher in women as compared to the corresponding male cohort (p<0.05).
Conclusion: There are significant sex-specific differences in coronary vascular function, vulnerable plaque composition and response to statin therapy; highlighting the necessity of sex-specific models to identify and manage atherosclerosis.
- © 2011 by American Heart Association, Inc.