Risk Factors for Coronary Heart Disease Differ For Men Versus Women

CHICAGO - The review of coronary angiography results have showed significant differences between men and women in risk factors for coronary artery disease as well as major adverse cardiac events, according to a study presented Wednesday at RSNA.

Coronary artery disease (CAD) involves a narrowing of the blood vessels that supply blood and oxygen to the heart. It is typically caused by a build-up of fat and other plaque forming on vessel walls. The Centers for Disease Control and Prevention has pinpointed heart disease as the leading cause of death for both men and women.

John W. Nance Jr., MD, a radiology resident at John Hopkins Hospital and a coauthor of the study, U. Joseph Schoepf, outlined the study on Wednesday. Researchers at the Medical University of South Carolina analyzed the results of coronary angiographies of 480 patients with a mean age of 55 that had acute chest pain. About 65 percent of the patients were female, 35 percent male.

The CT results are able to show the number of vessel segments with plaque, the severity of blockage and the composition of the plaque. Results were compared to data collected spanning a 12.8 month follow-up period. From this, researchers gathered information regarding the extent, severity and type of plaque build-up to correlate with occurrences of major adverse cardiac events, such as heart attack or bypass surgery.

The results were significantly different for men versus women, Nance said. In the total study period, 87 of the patients experienced major adverse cardiac events. The correlated results showed that women with a large amount of plaque build-up and extensive hardening of the arteries are at significantly greater cardiovascular risk than men.

Major adverse cardiac events risks were higher specifically in women than men when there was extensive build-up of plaque of any kind. Women with four or more vessel segments narrowed were also nearly twice as likely as men to have a greater extent of CAD.

When searching for risk factors associated with different types of plaque, however, men were at higher risk than women for major adverse cardiac events when their artery segments contained non-calcified plaque.
Nance said he believes the results of the study should serve as a hint to doctors when evaluating patients. “Doctors should consider these findings when seeing patients,” he said. “They should also have more optimized reporting.”

Nance also believes this should be yet another push for doctors to strive for providing more individualized care for their patients.