Key result
In asymptomatic women at low or intermediate risk, coronary vessel wall thickness measured at MRI was the primary independent surrogate of coronary artery disease, with a thickness >1.41 mm associated with significant disease (OR 1.61).
Why the study?
To evaluate the association between coronary vessel wall thickness measured by MRI and CAD risk in asymptomatic individuals at low and intermediate risk based on Framingham score.
Is coronary vessel wall thickness measured by MRI associated with CT angiography-based CAD scores in asymptomatic adults at low to intermediate risk?
Cross-Sectional (n=131)
Blinded assessors
No
Is coronary vessel wall thickness measured by MRI associated with CT angiography-based CAD scores in asymptomatic adults at low to intermediate risk?
Odds Ratio: 1.61 (95% CI 1.16–2.19)
Coronary vessel wall thickness measured by MRI is an independent surrogate marker for CAD in asymptomatic women at low to intermediate risk, highlighting sexual dimorphism in CAD risk factors.
MRI vessel wall thickness may aid CAD detection in low-risk women; leaves open outcome validation and risk model integration.
Purpose To demonstrate the association between coronary vessel wall thickness (VWT) measured at MRI and coronary artery disease (CAD) risk in asymptomatic groups at low and intermediate risk on the basis of Framingham score. Materials and Methods A total of 131 asymptomatic adults were prospectively enrolled. All participants underwent CT angiography for scoring CAD, and coronary VWT was measured at 3.0-T MRI. Nonlinear single and multivariable regression analyses with consideration for interaction with sex were performed to investigate the association of traditional atherosclerotic risk factors and VWT with CT angiography–based CAD scores. Results The analysis included 62 women and 62 men with low or intermediate Framingham score of less than 20%. Age (mean age, 45.0 years ± 14.5 [standard deviation]) and body mass index were not different between the groups. Age, sex, and VWT were individually significantly associated with all CT angiography–based CAD scores (P < .05). Additionally, sex was a significant effect modifier of the associations with all CAD scores. In men, age was the only statistically significant independent risk factor of CAD; in women, VWT was the only statistically significant independent surrogate associated with increased CAD scores (P < .05). Conclusion In asymptomatic women, VWT MRI was the primary independent surrogate of CAD, whereas age was the strongest risk factor in men. This study suggests that VWT may be used as a CAD surrogate in women at low or intermediate risk of CAD. Further longitudinal studies are required to determine the potential implication and use of this MRI technique for the preventative management of CAD in women.
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Ghanem et al. (2019) conducted a cross-sectional in Coronary Artery Disease (CAD) risk (n=131). Coronary vessel wall thickness (VWT) measured at MRI vs. Age, sex, and traditional risk factors was evaluated on Likelihood of segment involvement score > 5 and segment stenosis score > 5 in women (VWT > 1.41 mm) (OR 1.61, 95% CI 1.16-2.19). In asymptomatic women at low or intermediate risk, coronary vessel wall thickness measured at MRI was the primary independent surrogate of coronary artery disease, with a thickness >1.41 mm associated with significant disease (OR 1.61).
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