Prevalence of coronary artery disease in low to moderate-risk asymptomatic women: a multislice computed tomography study.
OBJECTIVE
Traditional risk factors may underestimate the burden of subclinical atherosclerosis in women. Recently, multislice computed tomography (MSCT) has become widely available in detecting early coronary artery disease (CAD). We sought the prevalence of CAD in low to moderate-risk asymptomatic women by MSCT coronary artery calcium (CAC) scoring and coronary angiography.


METHODS
The study included 185 women (mean age 57+/-12 years) without known CAD and diabetes, with low or moderate risk for CAD based on traditional risk scoring. Coronary artery calcium scoring and coronary angiography were performed by MSCT, which included a segment-based plaque detection and characterization of calcification. The plaques were classified based on the luminal stenotic effect (>50%). Patients with = or >1 stenotic plaque were classified as having obstructive CAD. Angiographic findings were compared with calcium scores.


RESULTS
Coronary artery calcium scoring and coronary angiography detected CAD in 63 (34.1%) and 100 (54.1%) women, respectively. In both groups, women were significantly older and had higher prevalences of hypertension and dyslipidemia. Coronary angiography showed CAD in 41 women (41%; 14.6% were obstructive) without CAC. These women were significantly younger than those with a positive CAC score (p<0.01). Age (p<0.02) and hypertension (p<0.05) were found as independent predictors of CAD detected by coronary angiography.


CONCLUSIONS
Multislice computed tomography identified a subset of low-risk women who might be at higher risk than that suggested by current risk stratification strategies. Women, especially having hypertension and dyslipidemia may be potential candidates for further risk stratification by MSCT coronary angiography.
Eroğlu
Elif
E
Department of Cardiology, Medicine Faculty of Yeditepe University, Istanbul, Turkey.
Bayrak
Fatih
F
Gemici
Gökmen
G
Güneysu
Tahsin
T
Mutlu
Bülent
B
Kalkan
Ali Kemal
AK
Değertekin
Muzaffer
M
D000367:Age Factors; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D015897:Comorbidity; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D006973:Hypertension / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*