Rate of Progression of Coronary Atherosclerotic Plaque in Women

Stephen J. Nicholls, Kathy Wolski, Ilke Sipahi, Paul Schoenhagen, Timothy Crowe, Samir R. Kapadia, Stanley L. Hazen, E. Murat Tuzcu, Steven E. Nissen

Research output: Contribution to journalArticle

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Abstract

Objectives: The purpose of this study was to determine the relationship between gender and the extent of coronary atherosclerosis assessed by intravascular ultrasound (IVUS) and its rate of progression in subjects treated with established medical therapies. Background: It is uncertain whether the pathophysiology of coronary artery disease (CAD) differs between genders. Methods: A systematic analysis was performed of 978 subjects who participated in serial studies of atheroma progression. Genders were compared with regard to the extent of coronary atheroma at baseline and subsequent change in response to use of established medical therapies. Results: Women were more likely to have a history of hypertension and higher levels of body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, C-reactive protein, and systolic and diastolic blood pressure. Despite this, women had less plaque in terms of percent atheroma volume (PAV) (33.9 ± 10.2% vs. 37.8 ± 10.3%, p < 0.001) and total atheroma volume (TAV) (148.7 ± 66.6 mm3 vs. 194.7 ± 84.3 mm3, p < 0.001). With medical therapy, the rate of change of PAV (0.7 ± 0.6% vs. 0.7 ± 0.5%, p = 0.92) and TAV (-2.3 ± 3.2 mm3 vs. -1.9 ± 2.9 mm3, p = 0.84) did not differ between genders. In the setting of intensive risk factor modification, there was no significant difference between genders with regard to the rates of plaque progression or regression. Conclusions: Despite the presence of more risk factors, the extent of atheroma in women with angiographic CAD is less than in men in subjects participating in clinical trials that employed serial assessments with IVUS. The finding that the rate of plaque progression or regression does not differ between genders in the setting of intensive risk factor modification supports the use of established medical therapies in women with CAD.

LanguageEnglish
Pages1546-1551
Number of pages6
JournalJournal of the American College of Cardiology
Volume49
Issue number14
DOIs
Publication statusPublished - 10 Apr 2007

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Nicholls, S. J., Wolski, K., Sipahi, I., Schoenhagen, P., Crowe, T., Kapadia, S. R., ... Nissen, S. E. (2007). Rate of Progression of Coronary Atherosclerotic Plaque in Women. Journal of the American College of Cardiology, 49(14), 1546-1551. https://doi.org/10.1016/j.jacc.2006.12.039
Nicholls, Stephen J. ; Wolski, Kathy ; Sipahi, Ilke ; Schoenhagen, Paul ; Crowe, Timothy ; Kapadia, Samir R. ; Hazen, Stanley L. ; Tuzcu, E. Murat ; Nissen, Steven E. / Rate of Progression of Coronary Atherosclerotic Plaque in Women. In: Journal of the American College of Cardiology. 2007 ; Vol. 49, No. 14. pp. 1546-1551.
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abstract = "Objectives: The purpose of this study was to determine the relationship between gender and the extent of coronary atherosclerosis assessed by intravascular ultrasound (IVUS) and its rate of progression in subjects treated with established medical therapies. Background: It is uncertain whether the pathophysiology of coronary artery disease (CAD) differs between genders. Methods: A systematic analysis was performed of 978 subjects who participated in serial studies of atheroma progression. Genders were compared with regard to the extent of coronary atheroma at baseline and subsequent change in response to use of established medical therapies. Results: Women were more likely to have a history of hypertension and higher levels of body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, C-reactive protein, and systolic and diastolic blood pressure. Despite this, women had less plaque in terms of percent atheroma volume (PAV) (33.9 ± 10.2{\%} vs. 37.8 ± 10.3{\%}, p < 0.001) and total atheroma volume (TAV) (148.7 ± 66.6 mm3 vs. 194.7 ± 84.3 mm3, p < 0.001). With medical therapy, the rate of change of PAV (0.7 ± 0.6{\%} vs. 0.7 ± 0.5{\%}, p = 0.92) and TAV (-2.3 ± 3.2 mm3 vs. -1.9 ± 2.9 mm3, p = 0.84) did not differ between genders. In the setting of intensive risk factor modification, there was no significant difference between genders with regard to the rates of plaque progression or regression. Conclusions: Despite the presence of more risk factors, the extent of atheroma in women with angiographic CAD is less than in men in subjects participating in clinical trials that employed serial assessments with IVUS. The finding that the rate of plaque progression or regression does not differ between genders in the setting of intensive risk factor modification supports the use of established medical therapies in women with CAD.",
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Nicholls, SJ, Wolski, K, Sipahi, I, Schoenhagen, P, Crowe, T, Kapadia, SR, Hazen, SL, Tuzcu, EM & Nissen, SE 2007, 'Rate of Progression of Coronary Atherosclerotic Plaque in Women', Journal of the American College of Cardiology, vol. 49, no. 14, pp. 1546-1551. https://doi.org/10.1016/j.jacc.2006.12.039

Rate of Progression of Coronary Atherosclerotic Plaque in Women. / Nicholls, Stephen J.; Wolski, Kathy; Sipahi, Ilke; Schoenhagen, Paul; Crowe, Timothy; Kapadia, Samir R.; Hazen, Stanley L.; Tuzcu, E. Murat; Nissen, Steven E.

In: Journal of the American College of Cardiology, Vol. 49, No. 14, 10.04.2007, p. 1546-1551.

Research output: Contribution to journalArticle

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T1 - Rate of Progression of Coronary Atherosclerotic Plaque in Women

AU - Nicholls, Stephen J.

AU - Wolski, Kathy

AU - Sipahi, Ilke

AU - Schoenhagen, Paul

AU - Crowe, Timothy

AU - Kapadia, Samir R.

AU - Hazen, Stanley L.

AU - Tuzcu, E. Murat

AU - Nissen, Steven E.

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Nicholls SJ, Wolski K, Sipahi I, Schoenhagen P, Crowe T, Kapadia SR et al. Rate of Progression of Coronary Atherosclerotic Plaque in Women. Journal of the American College of Cardiology. 2007 Apr 10;49(14):1546-1551. https://doi.org/10.1016/j.jacc.2006.12.039