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Review
. 2022 Mar-Apr;16(2):138-149.
doi: 10.1016/j.jcct.2021.09.004. Epub 2021 Oct 8.

The evolving role of coronary computed tomography in understanding sex differences in coronary atherosclerosis

Keva Garg  1 , Toral R Patel  2 , Arjun Kanwal  3 , Todd C Villines  2 , Niti R Aggarwal  4 , Khurram Nasir  5 , Roger S Blumenthal  1 , Michael J Blaha  1 , Pamela S Douglas  6 , Leslee J Shaw  7 , Garima Sharma  8
Affiliations
Review

The evolving role of coronary computed tomography in understanding sex differences in coronary atherosclerosis

Keva Garg et al. J Cardiovasc Comput Tomogr. 2022 Mar-Apr.

Abstract

Our understanding of sex differences in subclinical atherosclerosis and plaque composition and characteristics have greatly improved with the use of coronary computed tomography (CCTA) over the past years. CCTA has emerged as an important frontline diagnostic test for women, especially as we continue to understand the impact of non-obstructive atherosclerosis as well as diffuse, high risk plaque as precursors of acute cardiac events in women. Based on its ability to identify complex plaque morphology such as low attenuation plaque, high risk non calcified plaque, positive remodeling, fibrous cap, CCTA can be used to assess plaque characteristics. CCTA can avoid false positive of other imaging studies, if included earlier in assessment of ischemic symptoms. In the contemporary clinical setting, CCTA will prove useful in further understanding and managing cardiovascular disease in women and those without traditional obstructive coronary disease.

Keywords: And cardiac computed tomography; Atherosclerosis; Cardiovascular disease; Ischemic heart disease; Sex; Sex disparities; Women.

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Figures

Fig. 1.
Fig. 1.
Traditional and sex-specific risk factors in ischemic heart disease.
Fig. 2.
Fig. 2.. Use of Coronary Computed Tomography in Assessment of Plaque Composition and Characteristics
CCTA-coronary computed tomography angiography; FFR - fractional flow reserve; MLA - minimal lumen area; Vsub - subtended myocardial mass.
Fig. 3.
Fig. 3.
Characteristics of female sex in cardiac testing.
See this image and copyright information in PMC

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