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. 2018 Feb 13;9(1):9.
doi: 10.1186/s13293-018-0168-8.

Sex difference in clot lysability and association to coronary artery calcification

Ramshanker Ramanathan  1   2   3   4 , Niels Peter R Sand  5   6 , Johannes J Sidelmann  7   8 , Bjarne L Nørgaard  9 , Jørgen B Gram  7   8
Affiliations

Sex difference in clot lysability and association to coronary artery calcification

Ramshanker Ramanathan et al. Biol Sex Differ. .

Abstract

Background: Incidence and prevalence of cardiovascular disease (CVD) differ between sexes, and women experience CVD later than men. Changes in fibrin clot lysability are associated with CVD, and the present study addresses sex differences in fibrin clot lysability in asymptomatic middle-aged individuals and the relation to coronary artery calcification (CAC).

Methods: Participants free of morbidities and medication, N = 163, were randomly chosen from a national registry among citizens, 50 or 60 years of age, and were followed for 5 years. CAC was determined by the Agatston (Ag) score both at baseline and at follow-up. Based on the changes in Ag, the population was divided into two groups: ΔAg = 0 U or ΔAg > 0 U. Fibrin clot analyses were based on turbidimetric methods.

Results: At baseline, 116 women and 97 men were included; 84 women and 79 men completed the 5-year follow-up (77%). Independently of covariates, women with ΔAg > 0 had reduced mean (SD) fibrin lysability at follow-up, 40.2% (15.9), both in comparison to baseline, 47.8% (20.4), p = 0.001, to women with ΔAg = 0 U, 51.2% (24.5), p = 0.028, and to men with ΔAg > 0 U, 54.4% (21.0), p = 0.002.

Conclusions: Fibrin clot lysability changes over time with considerable sex differences. Women with progression of CAC have reduced fibrin clot lysability compared to men, indicating a sex-specific association between morphological vessel wall changes and fibrin clot lysability.

Keywords: Cardiovascular disease; Coronary artery calcification; Fibrin clot lysability; Sex difference.

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Conflict of interest statement

Ethics approval and consent to participate

All procedures performed in the study were conducted in accordance with the ethical standards of the Regional Scientific Ethics Committee for Southern Denmark and with the ethical guidelines of the 1975 Declaration of Helsinki and its later amendments. The protocol was approved by the Regional Scientific Ethics Committee for Southern Denmark, reference number S20080140 and S20130169 (45023). Written informed consent for study participation and publication of study results were obtained from all individual participants included in the study.

Competing interests

Author Bjarne L. Nørgaard has received research grant from Siemens, Edwards Lifesciences and Heartflow. All other authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Clot lysability in women with ΔAgatston score > 0 U at baseline and follow-up (N = 31). Variables are compared using the paired Student’s t test. Mean and SD are indicated in bars
Fig. 2
Fig. 2
Clot lysability in men (N = 47) and women (N = 31) with ΔAgatston score > 0 U at follow-up. Variables are compared using the unpaired Student’s t test. Mean and SD are indicated in bars
Fig. 3
Fig. 3
Clot lysability in women with ΔAgatston score = 0 U (N = 53) and ΔAgatston score > 0 U (N = 31) at follow-up. Variables are compared using the unpaired Student’s t test. Mean and SD are indicated in bars
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