Sex differences in diagnostic modalities of atherosclerosis in the macrocirculation

Kerkhof, Peter L.M.; Tona, Francesco

doi:10.1016/j.atherosclerosis.2023.117275

Cited by 12 publications

(1 citation statement)

References 107 publications

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“…Those in the coronary arteries have additionally lower volumes of fibrous tissue and fibro-fatty tissue, along with greater total plaque burden [148]. Overall, women have less vulnerable atherosclerotic plaques, and contrary to men, experience acute plaque rupture less frequently than plaque erosion [149]. Moreover, women are less likely to exhibit diffuse CAD or severe ischemia, but present with more frequent angina and microvascular disease as the underlying cause [150].…”

Section: Atherosclerotic Cardiovascular Disease In Womenmentioning

confidence: 99%

Sex aspects in lipoprotein metabolism, dyslipidemia, and lipid-lowering therapy: A comprehensive review

Zimodro,

Mucha,

Berthold

et al. 2024

Preprint

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Lipid-lowering therapy (LLT) is a cornerstone of atherosclerotic cardiovascular disease prevention. Although LLT might lead to different reductions in low-density lipoprotein cholesterol (LDL-C) levels in women and men, LLT diminishes cardiovascular risk equally effectively in both sexes. Despite similar LLT efficacy, the use of high-intensity statin, ezetimibe, and proprotein convertase subtilisin/kexin type 9 inhibitors is lower in women compared to men. Women achieve the guideline-recommended LDL-C levels less often than men. Greater cholesterol burden is particularly prominent in women with familial hypercholesterolemia. In clinical practice, women and men with dyslipidemia present with different cardiovascular risk profiles and disease manifestations. The concentrations of LDL-C, lipoprotein(a) and other blood lipids differ between women and men over a lifetime. Dissimilar levels of LLT’s target molecules partially result from sex-specific hormonal and genetic determinants of lipoprotein metabolism. Hence, to evaluate a potential need for sex-specific LLT, this comprehensive review (i) describes the impact of sex on lipoprotein metabolism and lipid profile, (ii) highlights sex differences in cardiovascular risk among patients with dyslipidemia, (iii) presents recent, up-to-date clinical trial and real-world data on LLT efficacy and safety in women, and (iv) discusses diverse medical needs of women and men with dyslipidemia and increased cardiovascular risk.

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Section: Atherosclerotic Cardiovascular Disease In Womenmentioning

confidence: 99%

Sex aspects in lipoprotein metabolism, dyslipidemia, and lipid-lowering therapy: A comprehensive review

Zimodro,

Mucha,

Berthold

et al. 2024

Preprint

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Sex-Specific Association Patterns of Bone Microstructure and Lower Leg Arterial Calcification

Bartosik,

Simon,

Busse

et al. 2024

Calcif Tissue Int

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In conversations about bone loss and the importance of calcium homeostasis, patients frequently inquire about the association with arterial calcifications. Although a relationship between bone loss and the occurrence of vascular calcifications is suspected, it is not yet fully investigated and understood. This study aims to analyze associations between bone mineralization, structure, and vascular calcification at the lower leg in patients with low bone mineral density in HR-pQCT. We retrospectively analyzed 774 high-resolution quantitative computed tomography (HR-pQCT) scans of the distal tibia for the presence of vascular calcifications. After sex-specific propensity score matching for age and BMI to account for confounders, 132 patients remained for quantification of bone microstructure, bone density, lower leg arterial calcification (LLAC), and laboratory parameters of bone turnover. The interactions between bone parameters and vascular calcification were quantified by regression analyses. The calcium metabolism was not different between individuals with and without LLAC, nor oral calcium supplementation. Female patients with LLAC had a higher cortical perimeter (p = 0.016) compared to female patients without LLAC, whereas male patients with LLAC had lower cortical pore diameter than male patients without LLAC (p = 0.027). The appearance of LLAC was sex specifically associated with bone parameters. In female patients, only plaque density was associated with HR-pQCT bone parameters and age, whereas in male patients, plaque volume was associated with HR-pQCT parameters of the distal tibia. Female patients exhibit an increasing plaque density depended on age and trabecular thinning. Decreasing cortical pore diameter and trabecular number along with increasing bone mineralization are linked to increasing plaque volume in male patients.

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Sex-specific differences in cardiovascular risk factors and implications for cardiovascular disease prevention in women

Rajendran,

Minhas,

Kazzi

et al. 2023

Atherosclerosis

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Sex differences in diagnostic modalities of atherosclerosis in the macrocirculation

Cited by 12 publications

References 107 publications

Sex aspects in lipoprotein metabolism, dyslipidemia, and lipid-lowering therapy: A comprehensive review

Sex aspects in lipoprotein metabolism, dyslipidemia, and lipid-lowering therapy: A comprehensive review

Sex-Specific Association Patterns of Bone Microstructure and Lower Leg Arterial Calcification

Sex-specific differences in cardiovascular risk factors and implications for cardiovascular disease prevention in women

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