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Sex differences in prevalence and characteristics of imaging-detected atherosclerosis : A population-based study

Swahn, Eva ; Sederholm Lawesson, Sofia ; Alfredsson, Joakim ; Fredrikson, Mats ; Angerås, Oskar ; Duvernoy, Olov ; Engström, Gunnar LU ; Eriksson, Maria J. ; Fagman, Erika and Johansson, Bengt , et al. (2024) In European Heart Journal Cardiovascular Imaging 25(12). p.1663-1672
Abstract

Aims: Men are more likely to suffer a myocardial infarction than women, but population-based studies on sex differences in imaging-detected atherosclerosis are lacking. The aims were to assess sex differences in the prevalence of imaging-detected coronary and carotid atherosclerosis, as well as multivariable adjusted associations between sex and atherosclerosis. Methods and results: Participants aged 50-65, recruited from the general population to the Swedish Cardiopulmonary bioImage Study (SCAPIS), were included in this population-based cross-sectional study. Comprehensive diagnostics, including coronary computed tomography angiography and carotid ultrasound, were performed. The image findings were any coronary atherosclerosis,... (More)

Aims: Men are more likely to suffer a myocardial infarction than women, but population-based studies on sex differences in imaging-detected atherosclerosis are lacking. The aims were to assess sex differences in the prevalence of imaging-detected coronary and carotid atherosclerosis, as well as multivariable adjusted associations between sex and atherosclerosis. Methods and results: Participants aged 50-65, recruited from the general population to the Swedish Cardiopulmonary bioImage Study (SCAPIS), were included in this population-based cross-sectional study. Comprehensive diagnostics, including coronary computed tomography angiography and carotid ultrasound, were performed. The image findings were any coronary atherosclerosis, coronary stenosis ≥ 50%, segment involvement score (SIS) ≥ 4, coronary artery calcium score (CACS) > 100, and any ultrasound-detected carotid plaque. In 25 580 participants (50% women), men had more hypertension (20.3% vs. 17.0%), hyperlipidaemia (9.0% vs. 5.5%), and diabetes (8.5% vs. 4.7%). The prevalence was 56.2% vs. 29.5% for any coronary atherosclerosis (P < 0.01), 9.0% vs. 2.3% for coronary stenosis ≥ 50% (P < 0.01), 20.2% vs. 5.3% for SIS ≥ 4 (P < 0.01), 18.2% vs. 5.6% for CACS > 100 (P < 0.01), and 60.9% vs. 48.7% for carotid plaque (P < 0.01), in men vs. women, respectively. Multivariable adjustment only marginally changed these associations: odds ratios (ORs) (95% confidence interval): 2.75 (2.53-2.99) for coronary atherosclerosis, 2.88 (2.40-3.45) for coronary stenosis ≥ 50%, 3.99 (3.50-4.55) for SIS ≥ 4, 3.29 (2.88-3.75) for CACS > 100, and 1.57 (1.45-1.70) for carotid plaque. Conclusion: Men had higher prevalence of imaging-detected carotid and coronary atherosclerosis with prevalence in women aged 65 corresponding to men 11-13 years younger. The associations remained after extensive multivariable adjustment.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
atherosclerosis, carotid artery disease, coronary artery disease, coronary computed tomography angiography, sex characteristics, ultrasonography
in
European Heart Journal Cardiovascular Imaging
volume
25
issue
12
pages
10 pages
publisher
Oxford University Press
external identifiers
  • pmid:39158095
  • scopus:85210956775
ISSN
2047-2404
DOI
10.1093/ehjci/jeae217
language
English
LU publication?
yes
id
1caede10-6670-4371-856c-7e2ec2fe0add
date added to LUP
2025-01-20 15:17:14
date last changed
2025-07-22 05:44:15
@article{1caede10-6670-4371-856c-7e2ec2fe0add,
  abstract     = {{<p>Aims: Men are more likely to suffer a myocardial infarction than women, but population-based studies on sex differences in imaging-detected atherosclerosis are lacking. The aims were to assess sex differences in the prevalence of imaging-detected coronary and carotid atherosclerosis, as well as multivariable adjusted associations between sex and atherosclerosis. Methods and results: Participants aged 50-65, recruited from the general population to the Swedish Cardiopulmonary bioImage Study (SCAPIS), were included in this population-based cross-sectional study. Comprehensive diagnostics, including coronary computed tomography angiography and carotid ultrasound, were performed. The image findings were any coronary atherosclerosis, coronary stenosis ≥ 50%, segment involvement score (SIS) ≥ 4, coronary artery calcium score (CACS) &gt; 100, and any ultrasound-detected carotid plaque. In 25 580 participants (50% women), men had more hypertension (20.3% vs. 17.0%), hyperlipidaemia (9.0% vs. 5.5%), and diabetes (8.5% vs. 4.7%). The prevalence was 56.2% vs. 29.5% for any coronary atherosclerosis (P &lt; 0.01), 9.0% vs. 2.3% for coronary stenosis ≥ 50% (P &lt; 0.01), 20.2% vs. 5.3% for SIS ≥ 4 (P &lt; 0.01), 18.2% vs. 5.6% for CACS &gt; 100 (P &lt; 0.01), and 60.9% vs. 48.7% for carotid plaque (P &lt; 0.01), in men vs. women, respectively. Multivariable adjustment only marginally changed these associations: odds ratios (ORs) (95% confidence interval): 2.75 (2.53-2.99) for coronary atherosclerosis, 2.88 (2.40-3.45) for coronary stenosis ≥ 50%, 3.99 (3.50-4.55) for SIS ≥ 4, 3.29 (2.88-3.75) for CACS &gt; 100, and 1.57 (1.45-1.70) for carotid plaque. Conclusion: Men had higher prevalence of imaging-detected carotid and coronary atherosclerosis with prevalence in women aged 65 corresponding to men 11-13 years younger. The associations remained after extensive multivariable adjustment.</p>}},
  author       = {{Swahn, Eva and Sederholm Lawesson, Sofia and Alfredsson, Joakim and Fredrikson, Mats and Angerås, Oskar and Duvernoy, Olov and Engström, Gunnar and Eriksson, Maria J. and Fagman, Erika and Johansson, Bengt and Johnson, Linda and Johnston, Nina and Ljungberg, Johan and Mannila, Maria and Nordendahl, Maria and Oldgren, Jonas and Omerovic, Elmir and Ostenfeld, Ellen and Persson, Margaretha and Rosengren, Annika and Skoglund Larsson, Linn and Sundström, Johan and Söderberg, Mia and Östgren, Carl Johan and Leander, Karin and Jernberg, Tomas}},
  issn         = {{2047-2404}},
  keywords     = {{atherosclerosis; carotid artery disease; coronary artery disease; coronary computed tomography angiography; sex characteristics; ultrasonography}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{1663--1672}},
  publisher    = {{Oxford University Press}},
  series       = {{European Heart Journal Cardiovascular Imaging}},
  title        = {{Sex differences in prevalence and characteristics of imaging-detected atherosclerosis : A population-based study}},
  url          = {{http://dx.doi.org/10.1093/ehjci/jeae217}},
  doi          = {{10.1093/ehjci/jeae217}},
  volume       = {{25}},
  year         = {{2024}},
}