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Sex Differences in Coronary Atherosclerosis

  • Women and Ischemic Heart Disease (J.M. Peña and F. Lin, Section Editors)
  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The importance of cardiovascular disease (CVD) in women has long been underestimated. Therefore, we need to understand the impact of sex differences on CVD.

Recent Findings

Traditional risk factors contribute to coronary artery disease (CAD) differently in women and men. There are female-specific risk factors and comorbid conditions that affect the risk of CAD. Plaque erosion is frequently seen in younger women who smoke, while plaque rupture is common in older women and men who have elevated blood cholesterol. Coronary artery calcification is also different in both sexes. Thus, coronary artery calcification score-based risk stratification in women is challenging.

Summary

A deeper understanding of the sex differences in the risk factors and plaque morphology of coronary atherosclerosis may lead to improved outcomes of CVD in women.

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Abbreviations

CVD:

Cardiovascular disease

CAD:

Coronary artery disease

CTO:

Chronic total occlusion

MMP:

Matrix metalloproteinase

IEL:

Internal elastic lamina

EEL:

External elastic lamina

CN:

Calcified nodule

CAC:

Coronary artery calcification

OR:

Odds ratio

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Authors and Affiliations

  1. CVPath Institute, Inc., Firstfield Rd 19, Gaithersburg, MD, USA

    Yu Sato, Rika Kawakami, Atsushi Sakamoto, Anne Cornelissen, Masayuki Mori, Kenji Kawai, Saikat Ghosh, Maria E. Romero, Frank D. Kolodgie, Aloke V. Finn & Renu Virmani

  2. School of Medicine, University of Maryland, Baltimore, MD, USA

    Aloke V. Finn

Authors
  1. Yu Sato
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  2. Rika Kawakami
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  3. Atsushi Sakamoto
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  4. Anne Cornelissen
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  5. Masayuki Mori
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  6. Kenji Kawai
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  7. Saikat Ghosh
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  9. Frank D. Kolodgie
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  11. Renu Virmani
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Corresponding author

Correspondence to Renu Virmani.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

Conflict of Interest

CVPath Institute have received institutional research support from NIH-HL141425, Leducq Foundation Grant, 4C Medical, 4Tech, Abbott Vascular, Ablative Solutions, Absorption Systems, Advanced NanoTherapies, Aerwave Medical, Alivas, Amgen, Asahi Medical, Aurios Medical, Avantec Vascular, BD, Biosensors, Biotronik, Biotyx Medical, Bolt Medical, Boston Scientific, Canon,Cardiac Implants, Cardiawave, CardioMech, Cardionomic, Celonova, Cerus, EndoVascular, Chansu Vascular Technologies, Childrens National, Concept Medical, Cook Medical, Cooper Health, Cormaze, CRL, Croivalve, CSI, Dexcom, Edwards Lifesciences, Elucid Bioimaging, eLum Technologies, Emboline, Endotronix, Envision, Filterlex, Imperative Care, Innovalve, Innovative, Cardiovascular Solutions, Intact Vascular,,Interface Biolgics, Intershunt Technologies, Invatin, Lahav, Limflow, L&J Bio, Lutonix, Lyra Therapeutics, Mayo Clinic, Maywell, MDS, MedAlliance, Medanex, Medtronic, Mercator, Microport, Microvention, Neovasc, Nephronyx, Nova Vascular, Nyra Medical, Occultech, Olympus, Ohio Health, OrbusNeich, Ossio, Phenox, Pi-Cardia, Polares Medical, Polyvascular, Profusa, ProKidney, LLC, Protembis, Pulse Biosciences, Qool Therapeutics, Recombinetics, Recor Medical, Regencor, Renata Medical, Restore Medical, Ripple Therapeutics, Rush University, Sanofi, Shockwave, SMT, SoundPipe, Spartan Micro, Spectrawave, Surmodics, Terumo Corporation, The Jacobs Institute, Transmural Systems, Transverse Medical, TruLeaf, UCSF, UPMC, Vascudyne, Vesper, Vetex Medical, Whiteswell, WL Gore, Xeltis. A.V.F. has received honoraria from Abbott Vascular; Biosensors; Boston Scientific; Celonova; Cook Medical; CSI; Lutonix Bard; Sinomed; Terumo Corporation; and is a consultant to Amgen; Abbott Vascular; Boston Scientific; Celonova; Cook Medical; Lutonix Bard; Sinomed. R.V. is a consultant/scientific advisory board member of Abbott Vascular; Bosten Scientific; Celonova; Cook Medical; CSI; Edwards Lifesciences; Bard BD; Medtronic; OrbusNeich Medical; ReCor Medical; SinoMedical Sciences Technology; Surmodics; Terumo Corporation; W. L. Gore; Xeltis. All other authors declare no competing interests.

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Sato, Y., Kawakami, R., Sakamoto, A. et al. Sex Differences in Coronary Atherosclerosis. Curr Atheroscler Rep 24, 23–32 (2022). https://doi.org/10.1007/s11883-022-00980-5

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