Prevalence of coronary artery disease in low to moderate-risk asymptomatic women: a multislice computed tomography study [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2008; 36(7): 439-445

Prevalence of coronary artery disease in low to moderate-risk asymptomatic women: a multislice computed tomography study

Elif Eroğlu1, Fatih Bayrak1, Gökmen Gemici1, Tahsin Güneysu2, Bülent Mutlu3, Ali Kemal Kalkan1, Muzaffer Değertekin1
1Yeditepe University Hospital, Department of Cardiology, Istanbul, Turkey
2Sonomed Imaging Center, Department of Cardiovascular Imaging, Istanbul, Turkey
3Kartal Kosuyolu Yuksek Ihtisas Heart And Research Hospital, Department of Cardiology, Istanbul, Turkey


OBJECTIVES
Traditional risk factors may underestimate the burden of subclinical atherosclerosis in women. Recently, multislice computed tomography (MSCT) has become widely available in detecting early coronary artery disease (CAD). We sought the prevalence of CAD in low to moderate-risk asymptomatic women by MSCT coronary artery calcium (CAC) scoring and coronary angiography.

STUDY DESIGN
The study included 185 women (mean age 57±12 years) without known CAD and diabetes, with low or moderate risk for CAD based on traditional risk scoring. Coronary artery calcium scoring and coronary angiography were performed by MSCT, which included a segment-based plaque detection and characterization of calcification. The plaques were classified based on the luminal stenotic effect (>50%). Patients with ≥1 stenotic plaque were classified as having obstructive CAD. Angiographic findings were compared with calcium scores.

RESULTS
Coronary artery calcium scoring and coronary angiography detected CAD in 63 (34.1%) and 100 (54.1%) women, respectively. In both groups, women were significantly older and had higher prevalences of hypertension and dyslipidemia. Coronary angiography showed CAD in 41 women (41%; 14.6% were obstructive) without CAC. These women were significantly younger than those with a positive CAC score (p<0.01). Age (p<0.02) and hypertension (p<0.05) were found as independent predictors of CAD detected by coronary angiography.

CONCLUSION
Multislice computed tomography identified a subset of low-risk women who might be at higher risk than that suggested by current risk stratification strategies. Women, especially having hypertension and dyslipidemia may be potential candidates for further risk stratification by MSCT coronary angiography.

Keywords: Atherosclerosis, calcinosis/radiography, coronary angiography, coronary artery disease; coronary stenosis; female; risk assessment; tomography, X-ray computed/methods

How to cite this article
Elif Eroğlu, Fatih Bayrak, Gökmen Gemici, Tahsin Güneysu, Bülent Mutlu, Ali Kemal Kalkan, Muzaffer Değertekin. Prevalence of coronary artery disease in low to moderate-risk asymptomatic women: a multislice computed tomography study. Turk Kardiyol Dern Ars. 2008; 36(7): 439-445

Corresponding Author: Muzaffer Değertekin, Türkiye
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