Women Have About 12-Year Delay in Onset of Atherosclerosis

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Women with highest atherosclerotic burden have higher risk for MACE than men, especially postmenopausal women

By Elana Gotkine HealthDay Reporter

THURSDAY, May 11, 2023 (HealthDay News) — Women have an approximately 12-year delay in the onset of coronary atherosclerosis, but those in the highest atherosclerotic burden group have a higher risk for major adverse cardiovascular events (MACE), according to a study published online May 11 in the European Heart Journal: Cardiovascular Imaging. The research was published to coincide with EACVI 2023, the congress of the European Association of Cardiovascular Imaging, held from May 10 to 12 in Barcelona, Spain.

Sophie E. van Rosendael, M.D., from the Leiden University Medical Center in the Netherlands, and colleagues examined the differences in age onset and prognostic significance of atherosclerotic plaque burden between sexes in 11,678 women and 13,272 men who were followed for 3.7 years. The Leiden coronary computed tomography angiography (CCTA) score was calculated for all participants.

The researchers found that in women, the age where the median risk score was greater than 0 was 12 years higher than in men (64 to 68 versus 52 to 56 years). There was an independent association for the Leiden CCTA risk score with MACE (hazard ratios for scores 6 to 20 and >20, respectively: 2.29 and 6.71 in women and 1.64 and 2.38 in men). Within the highest-score group, the risk was significantly higher for women. The risk score was equally predictive and comparable for premenopausal women and men. In postmenopausal women, the prognostic value was higher than for men (hazard ratios for scores 6 to 20 and >20, respectively, 2.21 and 6.11 in women and 1.57 and 2.25 in men), with a significant interaction seen for the highest-risk group.

“The study suggests that a given burden of atherosclerosis is riskier in postmenopausal women than it is in men of that age,” van Rosendael said in a statement.

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