Key result
Female sex was associated with similar overall endothelial shear stress-related plaque progression compared to male sex (p=0.62), but with more marked progression in women <55 years (p=0.007).
Why the study?
Clinical atherosclerosis manifestations differ between women and men, and it was unknown whether anatomical characteristics and endothelial shear stress-related plaque growth in human coronary arteries also differ by sex.
Cohort (n=1,183)
Effect estimate: β: -0.62 ± 0.13 vs -0.68 ± 0.05
p-value: p=0.62
While overall endothelial shear stress-related plaque progression is similar between sexes, young women (<55 years) exhibit significantly more marked ESS-related plaque growth compared to men of the same age.
BACKGROUND AND AIMS: Clinical atherosclerosis manifestations are different in women compared to men. Since endothelial shear stress (ESS) is known to play a critical role in coronary atherosclerosis development, we investigated differences in anatomical characteristics and endothelial shear stress (ESS)-related plaque growth in human coronary arteries in men compared to women. METHODS: 1183 coronary arteries (male/female: 944/239) from the PREDICTION study were studied for differences in artery/plaque and ESS characteristics, and ESS-related plaque progression (6-10 months follow-up) among men and women and after stratification for age. All characteristics were derived from IVUS-based vascular profiling and reported per 3 mm-segments (13,030 3-mm-segments (male/female: 10,465/2,565)). RESULTS: Coronary arteries and plaques were significantly smaller in females compared to males; but no important differences were observed in plaque burden, ESS and rate of plaque progression. Change in plaque burden was inversely related to ESS (p<0.001) with no difference between women versus men (β: -0.62 ± 0.13 vs -0.68 ± 0.05, p=0.62). However, stratification for age demonstrated that ESS-related plaque growth was more marked in young women compared to men (<55 years, β: -2.02 ± 0.61 vs -0.33 ± 0.10, p=0.007), reducing in magnitude over the age-categories up till 75 years. CONCLUSIONS: Coronary artery and plaque size are smaller in women compared to men, but ESS and ESS- related plaque progression were similar. Sex-related differences in ESS-related plaque growth were evident after stratification for age. These observations suggest that although the fundamental processes of atherosclerosis progression are similar in men versus women, plaque progression may be influenced by age within gender.
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Wentzel et al. (2021) conducted a cohort in Coronary atherosclerosis (n=1,183). Female sex vs. Male sex was evaluated on Endothelial shear stress (ESS)-related plaque progression (change in plaque burden) (β: -0.62 ± 0.13 vs -0.68 ± 0.05, p=0.62). Female sex was associated with similar overall endothelial shear stress-related plaque progression compared to male sex (p=0.62), but with more marked progression in women <55 years (p=0.007).
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