CT Angiography Shows Heart Disease Similar in Men and Women

CHICAGO - Coronary computed tomography angiography (CCTA) revealed that mild coronary disease and cardiovascular risk is similar among both men and women, according to a study presented this week at RSNA 2013.

Researchers from St. Paul’s Hospital in Vancouver, Canada, undertook their study to determine whether men and women with the same extend of coronary artery disease (CAD) and similar risk profiles had the same prognoses. 

"There is a tendency to think women's heart disease is very different than men's heart disease,” Jonathan Leipisc, MD, said in a release. “Our data show that once plaque accumulates in the coronary arteries, the prognosis is very similar between men and women." Leipisc is the director of medical imaging at the hospital.

For the study, the researchers identified 18,158 patients without known CAD and normal CCTA or who had nonobstructive disease from data obtained from the Coronary CT Angiography Evaluation For Clinical Outcomes: An International Multicenter (CONFIRM) Registry. The 8,808 women and 9,350 men were matched by cardiovascular risk factors and the extent of heart disease as determined by CCTA, resulting in a one-to-one cohort of 11,462 patients.

Follow-up was an average of 2.3 years. The results showed that major adverse cardiac events (MACE) occurred in 251 patients (0.6 percent annual event). Women were more likely to be dyslipidemic, hypertensive, diabetic, and have a family history of CAD, while men were more likely to have higher Framingham risk score. Nonobstructive CAD conferred a similar adverse risk of death or heart attack in both men and women. Conversely, the absence of plaque on CCTA conferred a good prognosis for both men and women. 

"This analysis is exciting, because this has never been shown before," Leipsic said. "There's a prevailing belief that mild CAD puts women at greater risk for a major cardiac event compared to men with mild CAD. Our findings show this is just not true."