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Coronary wall thickness may be CAD risk factor in asymptomatic women
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Among asymptomatic women, the use of MRI in measuring coronary vessel wall thickness may help determine risk for CAD, according to findings published in Radiology: Cardiothoracic Imaging.
The researchers also found that age was a strong risk factor in men.
Khaled Z. Abd-Elmoniem, PhD, MHS, and colleagues investigated the association between coronary vessel wall thickness measured by MRI and CAD risk in asymptomatic groups at low and intermediate risk based on the Framingham score.
“A single image and measurement of coronary vessel wall thickness with MRI can be used to gauge the extent of coronary plaque in asymptomatic women, who then can be appropriately referred for further exams and/or treatment,” Abd-Elmoniem, of the National Institute of Diabetes and Digestive and Kidney Diseases at the NIH, said in a press release.
The researchers analyzed data from 131 asymptomatic adults enrolled in the study. CTA was performed on the participants for scoring CAD and coronary vessel wall thickness was measured by 3-T MRI. Nonlinear single and multivariable analyses were performed to determine the association of traditional atherosclerotic risk factors and vessel wall thickness with CTA-based CAD scores.
There were 124 patients (mean age, 45 years; 50% women) with a low or intermediate Framingham score of less than 20%, Abd-Elmoniem and colleagues reported. Age, sex and vessel wall thickness were individually associated with all CTA-based CAD scores (P < .05).
Sex was a significant effect modifier of the associations with all CAD scores, the researchers wrote.
In men, age was the only independent risk factor for CAD, while in women, vessel wall thickness was the only independent surrogate linked to increased CAD scores (P < .05 for both), the researchers wrote.
Abd-Elmoniem and colleagues wrote that the findings suggest vessel wall thickness should be used as a CAD surrogate in women at low or intermediate risk for CAD.
“Despite the significant advances in [coronary] CTA technology, it is not appropriate to send all asymptomatic people to [coronary] CTA because of the exposure to radiation and chemical dyes used for imaging,” Abd-Elmoniem, said in the release. “MRI might be a safe alternative that can be used more broadly to assist in the diagnosis of coronary artery disease without exposing patients to a procedure that carries some risk. The advantage of MRI in this situation is that it can tell us that there is a thickening before stenosis, which is difficult to do with [coronary] CTA.” – by Earl Holland Jr.
Disclosure: Abd-Elmoniem is an employee of the NIH.
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