Women may develop risk of heart attack even at lower levels of plaque deposition in arteries: Study

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Women may develop a risk of heart attack even at lower levels of plaque deposition in the arteries, according to a study. Women are known to typically have lower amounts of artery-clogging plaque compared to men. However, researchers, including those from Harvard Medical School in the US, said it is unknown how difference in plaque levels impacts one's risk of a major adverse cardiovascular event.

"Our findings underscore that women are not 'protected' from coronary events despite having lower plaque volumes," senior author Borek Foldyna, an assistant professor of radiology at Harvard Medical School said. "Because women have smaller coronary arteries, a small amount of plaque can have a bigger impact. Moderate increases in plaque burden appear to have disproportionate risk in women, suggesting that standard definitions of high risk may underestimate risk in women," Foldyna said.

The study, published in the Circulation: Cardiovascular Imaging journal, analysed data of more than 4,200 outpatients with chest pain and no history of coronary artery disease. Total plaque volume and total plaque burden -- amount of plaque relative to the size of the blood vessel -- were measured. Researchers found that despite having lower plaque volumes and fewer plaques with high-risk characteristics, women experienced similar rates of major adverse cardiovascular events as men.

"Among 4,267 patients (2,199 women), plaque was less frequent in women (55 per cent versus 75 per cent), with lower total plaque volume but similar total PB (plaque burden) and incident major adverse cardiovascular events (2.3 per cent versus 3.4 per cent)," the authors wrote. "Major adverse cardiovascular event risk became elevated at lower PB (plaque burden) in women than in men," they said.

Risk of a major adverse cardiovascular event emerged at 20 per cent total plaque burden among women and 28 per cent for men. Further, the risk increased more steeply at lower plaque burden levels for women, while in men, the risk increased gradually, requiring larger amounts of plaque, the researchers said. The findings suggest that sex-specific factors need to be incorporated while interpreting coronary plaque metrics and may help advance tailored approaches to classify cardiac risk, they said.

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