Coronary CT was prescribed more often in older women with chest pain/dyspnea who had lower calcified plaque burden and similar significant coronary lesions compared to men.
Are there gender differences in the use, testing sequence, and findings of coronary CT in patients with chest pain or dyspnea?
In patients with chest pain or dyspnea, women undergo coronary CT more frequently and often as a first-line test compared to men, presenting with lower calcified plaque burden but similar rates of significant coronary lesions.
Absolute Event Rate: 0% vs 0%
Abstract Background Coronary CT is a relevant evidence-based tool in the work-out of dyspnea or chest pain studies. Some features of women with chest pain or dyspnea can determine the different sensitivity or specificity of the main available diagnostic tests, with a preference for anatomic imaging tests. Aim of the study: we evaluated the gender perspective in the use of coronary CT in patients with chest pain or dyspnea in a tertiary hospital. Methods we retrospectively analysed 204 successive coronary CT studies, we evaluated the baseline characteristics of the patients, risk factors profile, type of clinical presentation. The sequence of tests solicitated by the cardiologist and their results were also evaluated after a medical records revision. Qualitative variables were analysed with the Chi-square test or the Fisher exact test, and quantitative variables with the t student test. Results (see table) The prescription of coronary CT was more frequent in women (63%), with an older average age. A previous condition of ischemic coronary disease was present in 6% of the patients, and 60% were considered to have "atypical symptoms". The prevalence of CV risk factors was similar in both genders, except from tobacco use that was more frequent in men. A previous antiplatelet treatment was more common in women, with no differences in previous statin use. In 51% of patients, the coronary CT was prescribed after a functional test (positive result 20% in women vs 30% in men, non-conclusive result 26% in women vs 15%). The average Agatston score was lower in women (CAC100 in 25% women vs 36% men). Despite their older age, we found a trend to a higher proportion of women with CAC=0 in women (42% vs 36%). A noninvasive contrast angiography was performed in 85% of women and 82% of men, with no differences in the number of significant coronary lesions (50%), but a lower proportion of vulnerable plaques in women. Conclusion In our experience in a tertiary hospital, the use of coronary CT in patients with chest pain or dyspnea is more frequent in women, with a significant older average age than men but a similar CV risk profile. The most frequent sequence is to prescribe coronary CT as a first test in women, and after a functional test in men. Despite their older age, women had a lower burden of calcified plaque and a similar proportion of significant coronary lesions.Results: gender differences Gender differences figure
Dalmau et al. (Sat,) reported a other. Coronary CT was prescribed more often in older women with chest pain/dyspnea who had lower calcified plaque burden and similar significant coronary lesions compared to men.