Women with mild forms of heart disease are thought to be at greater risk of one day having a major cardiac event and maybe dying from it. An international study has challenged this belief.
Men and women who have similar forms of coronary artery disease — characterized by plaque build-up in the heart’s main arteries — have similar heart attack and death risks, according to the new study.
The study analyzed information on thousands of people from around the world to reach this conclusion.
Researchers under the direction of Jonathon Leipsic, MD, FRCPC, director of medical imaging at St. Paul's Hospital in Vancouver, British Columbia, sought to evaluate how coronary artery disease affected the heart attack and death risks of men and women.
Coronary artery disease (CAD) results from fatty deposits called plaque building up in the major arteries that supply oxygen-filled blood to the heart muscle. Over time, this build-up can cause blockages that narrow or damage the arteries, which can eventually lead to a heart attack or death.
A test called coronary computed tomography angioplasty (CCTA), a noninvasive imaging study, is used to measure the amount of plaque inside the arteries. When there is less than a 50 percent plaque blockage, the condition is known as non-blockage coronary artery disease.
For this study, investigators reviewed data from the COronary CT Angiography EvaluatioN For Clinical Outcomes: An InteRnational Multicenter (CONFIRM) Registry, which contains information on 27,725 individuals from six countries who have undergone CCTA.
From this group, the research team focused on 18,158 patients with no known coronary artery disease or non-blockage CAD. Individuals were matched according to any cardiovascular disease risk factors they had and the extent of their CAD as measured by CCTA. The one-to-one matching resulted in a group of 11,462 people.
According to the researchers, the women in the final cohort (group) were more likely to have a family history of CAD, have abnormal cholesterol levels and high blood pressure, and be diabetic. The men were more likely to have a higher Framingham score, which predicts a person’s chance of having a heart attack in the next 10 years.
A statistical analysis of this group showed the risk of heart attack or death was similar in both men and women. Likewise, when CCTA showed no plaque build-up, men and women both had a similarly positive outlook.
“Our data confirms similar risk of non-obstructive CAD on CCTA between men and women helping to better understand CAD-related sex differences,” the authors wrote.
Dr. Leipsic said in a statement, "This analysis is exciting, because this has never been shown before. 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."
Results from this study were presented at the annual meeting of the Radiological Society of North America (RSNA).
Several of the authors disclosed financial ties with various commercial enterprises.
All research is considered preliminary before being published in a peer-reviewed journal.
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