title: Assessment of sex differences in plaque morphology by coronary computed tomography angiography--are men and women the same?
abstract: OBJECTIVE
  The objective of this study was to assess whether sex differences exist in plaque burden and plaque subtype as assessed by coronary computed tomography angiography (CCTA).
  
  
  METHODS
  The study cohort included 937 consecutive patients who underwent CCTA between 2008 and 2010. Stenosis was quantified using the Society of Cardiovascular Computed Tomography stenosis grading scale and a total stenosis score (TSS) was generated. Plaque morphology (PM) was reported as predominantly calcified (CP), noncalcified (NCP), or mixed (MP) plaque, and CP, NCP, and MP percentages were calculated.
  
  
  RESULTS
  On multivariate analysis, men were significantly more likely to have plaque (65.9% of men vs. 44.6% of women, p<0.001), at least one segment with ≥50% stenosis (22.7% of men vs. 10.3% of women, p<0.001) and higher TSS (mean score=2.81 for men vs. 1.58 for women, p<0.001). Sex was the strongest predictor in all models (odds ratio [OR]=2.55, 95% confidence interval [CI] 1.78-3.67, p<0.001 for any plaque; OR=2.48, 95% CI 1.48-4.16, p<0.01 for segments with ≥50% stenosis; β=1.46, 95% CI 0.69-2.22, p<0.001 for TSS). Among patients with coronary plaque present, no significant sex differences in PM were found.
  
  
  CONCLUSIONS
  Sex was the strongest risk factor for the presence and extent of plaque. Significant sex differences in PM did not exist.
authors.affiliation: 1 Department of Radiology and Department of Medicine, Division of Cardiology, University of British Columbia , Vancouver, British Columbia, Canada .
authors.forename: Gilat L
authors.initials: GL
authors.lastname: Grunau
authors.forename: Amir
authors.initials: A
authors.lastname: Ahmadi
authors.forename: Saman
authors.initials: S
authors.lastname: Rezazadeh
authors.forename: Reza
authors.initials: R
authors.lastname: Faraji
authors.forename: Sima
authors.initials: S
authors.lastname: Amid
authors.forename: Tim
authors.initials: T
authors.lastname: O'Connell
authors.forename: Brett
authors.initials: B
authors.lastname: Heilbron
authors.forename: Jonathon
authors.initials: J
authors.lastname: Leipsic
authors.forename: Carolyn M
authors.initials: CM
authors.lastname: Taylor
mesh_terms: D000328:Adult; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012727:Sex Characteristics; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000379:methods