Sex differences in coronary plaque composition evaluated by coronary computed tomography angiography in newly diagnosed Type 2 diabetes: association with low‐grade inflammation

Abstract Aim To determine differences in coronary plaque composition and inflammatory biomarkers between men and women with newly diagnosed Type 2 diabetes without known cardiovascular disease. Methods A total of 88 people with newly diagnosed (0.05). The median (quartiles) serum levels of fibrinogen 10.9 (9.8–12.6) μmol/l vs 9.7 (8.8–10.9) μmol/l, fibrin d‐dimer 0.3 (0.2–0.4) mg/l vs 0.27 (0.2–0.4) mg/l and C‐reactive protein 3.1 (1.1–5.2) mg/l vs (0.8–2.6) 1.6 mg/l were significantly higher in women (all P <0.05). Overall, men more often had multi‐vessel involvement 28 men (47%) vs 4 women (14%), and higher total plaque burden median (quartiles) 11.6 (2.3–36.0)% vs 2.0 (0.4–5.4)%; both P <0.05. The median (quartiles) total plaque volume 269.9 (62.6–641.9) mm 3 vs 61.1 (7.6–239.9) mm 3 and absolute calcified plaque volume 33.5 (8.3–148.3) mm 3 vs 4.7 (0.9–17.3) mm 3 were higher in men (both P <0.05). Women had a lower relative proportion of the calcified plaque component median (quartiles) 7.8 (4.7–15.4)% vs 23.7 (8.4–31.1)% and a higher relative proportion (median quartiles) of the non‐low‐density non‐calfied plaque component 77.6 (66.0–86.0)% vs 63.6 (54.0–72.9)%; both P <0.05. Conclusions In people with newly diagnosed Type 2 diabetes, women had lower absolute coronary plaque volumes but a more unfavourable plaque composition and enhanced systemic inflammation compared with men.