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Plaque composition, morphology does not differ by sex in patients with stable CAD

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CHICAGO — Except for a greater plaque burden in men, women and men with stable CAD have similar plaque morphology and composition, according to data presented at the American College of Cardiology Scientific Session.

The researchers retrospectively analyzed data from 383 patients (268 men, 115 women) who underwent multimodality intravascular imaging. All patients underwent OCT, and 128 of the patients also underwent IVUS/near infrared spectroscopy.

The women were older (aged 66 years vs. 62 years; P = .002) and had more comorbidities, including hypertension, diabetes with insulin use and obesity. Women also were more likely to present with Canadian Cardiovascular Society grade III or IV angina (78% vs. 63%; P = .019). However, more men had prior PCI compared with women (48% vs. 29%; P = .001).

The results were simultaneously published in JACC: Cardiovascular Imaging.

According to results, OCT showed no sex-specific differences in lipid arc, lipid volume index, thin cap fibrous atheroma, microvessels, macrophages or calcification. Nor were any differences observed in maximum lipid core body index by near-infrared spectroscopy. IVUS, however, revealed an increase in plaque burden in men compared with women in the reference segment (44.4 vs. 39.3; P = .031).

Because of their findings, the researchers wrote, “equally aggressive primary and secondary prevention measures must be undertaken irrespective of sex.

“This is especially important in the light of the findings from studies that have shown clear sex biases in the use of evidence-based medical therapy,” they wrote.

In a related editorial, Eloisa Arbustini, MD, of the Center for Inherited Cardiovascular Diseases, Transplant Research Area, Pavia, Italy, and colleagues wrote that these findings encourage “the development of novel models of research that should specifically focus on female CAD,” specifically the “investigation of female-specific risk factors such as autoimmune diseases, thyroid dysfunction, and hormone- and pregnancy-related risk.”

Arbustini and colleagues also emphasized the need for “comparative studies in subgroups of affected vs. non-affected women, or women carrying known risk factors vs. sex-specific factors.” – by Tracey Romero

References:

Bharadwaj A, et al. Poster 1104-104. Presented at: American College of Cardiology Scientific Session; April 2-4, 2016; Chicago.

Arbustini E, et al. JACC Cardiovasc Imaging. 2016;doi:10.1016/j.jcmg.2016.02.014.

Bharadwaj A, et al. JACC Cardiovasc Imaging. 2016;doi:10.1016/j.jcmg.2016.02.007.

Disclosure: One researcher reports receiving speaking fees from Abbott, Boston Scientific, Cardiovascular Systems Inc. and TriReme Medical. One editorialist reports receiving consultant fees from St. Jude Medical.