Key result
Female coronary arteries have less plaque than males but show similar shear stress-related plaque progression.
Why the study?
Atherosclerosis manifests differently by sex, prompting the hypothesis that female versus male coronary arteries have different endothelial shear stress and shear-stress-related plaque progression.
Does female sex compared to male sex affect endothelial shear stress and ESS-related plaque progression in human coronary arteries?
Observational (n=1,183)
Does female sex compared to male sex affect endothelial shear stress and ESS-related plaque progression in human coronary arteries?
Despite smaller vessel and plaque sizes in women, endothelial shear stress and its relationship to plaque progression do not differ significantly between sexes.
Similar shear stress despite smaller female arteries and less plaque does not explain sex differences; leaves open other progression mechanisms for study.
Background Atherosclerosis manifests itself differently in women compared to men. Since the pathophysiology of atherosclerotic plaques is known to be related to endothelial shear stress (ESS), it was hypothesized that female compared to male coronary arteries demonstrate a different i) ESS and ii) ESS related plaque progression. Methods 1183 coronary arteries (male/female:944/239) from the PREDICTION trial were studied for differences in vessel geometry (plaque area (PA) and lumen area (LA)), hemodynamic parameters (flow, minimal ESS over 90 degree arc (minESS) and maximal ESS over 90 degree arc (maxESS)) and ESS related plaque progression (1 year follow up) measured as change in maximal plaque thickness and plaque burden comparing female to male arteries. Arterial geometry and ESS measures were derived from IVUS-based vascular profiling and reported per 3 mm segments. For plaque progression studies minESS was subdivided into low, mid and high (<1,1–1.7,>1.7 Pa). To test statistical differences univariate anova or linear mixed models were used. Results 13030 3mm-segments (m/f: 10.465/2565) were analyzed. Female compared to male coronary arteries were smaller and presented with less plaque area (Table I). No differences in average ESS, minESS and maxESS were found for male versus female coronary arteries, partly explained by the lower flows in female arteries (Table I). The ESS-related plaque growth showed for both sexes an significant inverse relationship between maximal wall thickness (Figure, left) and plaque burden (Figure, right) and the three minESS categories. However, ESS-related plaque growth was not different for male vs females. Conclusion Our data demonstrated that vessel and plaque size are smaller in female compared to male coronary arteries. However, ESS and ESS related plaque progression were not different. Shear stress related plaque progression Funding Acknowledgement Type of funding source: None
No takes yet. Share an insight, caveat, or question.
Wentzel et al. (2020) conducted an observational in Atherosclerosis (n=1,183). Female sex vs. Male sex was evaluated on Endothelial shear stress (ESS) related plaque progression (change in maximal plaque thickness and plaque burden). Female coronary arteries were smaller and had less plaque area compared to male arteries, but endothelial shear stress and shear stress-related plaque progression were not different.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: