While atherosclerotic plaques in the coronary arteries are less frequent and smaller in volume among women compared to men, this fact does not diminish the likelihood of experiencing a heart attack or other severe cardiac issues. This finding comes from experts at the Katz Institute for Women’s Health, as reported by the journal Circulation: Cardiovascular Imaging.
The researchers analyzed data from over 4,200 individuals of both sexes. Participants in this study were patients presenting with stable angina who had no prior diagnosis of coronary artery disease. All subjects underwent coronary computed tomography angiography—a specialized procedure enabling visualization of the heart arteries’ condition and the measurement of plaque size. The observation period for these patients spanned roughly two years.
The work revealed that plaques were detected in 55 percent of women and 75 percent of men. Furthermore, the average size of the atherosclerotic deposits in female patients was approximately half that found in men—around 78 cubic millimeters versus 156 in men. Despite this difference, the incidence of adverse outcomes, such as myocardial infarction, death, or hospitalization due to chest pain, was comparable: 2.3 percent for women and 3.4 percent for men.
Further analysis indicated that for an equivalent plaque volume, the risk of cardiovascular events escalated sooner in women. Specifically, their probability of experiencing complications increased once approximately 20 percent of the artery’s lumen was affected, whereas this benchmark stood at about 28 percent for men. As plaque size increased, the danger level rose more rapidly for women.
The investigators theorize that the smaller dimensions of coronary arteries in women render them more susceptible even to minor atherosclerotic impairment. In the authors’ view, the current standards utilized for assessing cardiovascular disease risk may be underestimating the danger faced by female patients and thus require revision to incorporate these specific considerations.
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