Sex-related differences in coronary and carotid vessel geometry, plaque composition and shear stress obtained from imaging

• Published in: Atherosclerosis 2024-08, Vol.395, p.117616, Article 117616
• Main Authors: Wentzel, J.J., Bos, D., White, S.J., van der Heiden, K., Kavousi, M., Evans, P.C.
• Format: Article
• Language: English
• Subjects: Carotid Arteries - diagnostic imaging; Carotid Arteries - pathology; Carotid Arteries - physiopathology; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - pathology; Coronary Angiography; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - pathology; Coronary Artery Disease - physiopathology; Coronary Vessels - diagnostic imaging; Coronary Vessels - pathology; Disease Progression; Female; Humans; Male; Plaque, Atherosclerotic; Predictive Value of Tests; Risk Factors; Sex Factors; Stress, Mechanical
• ISSN: 0021-9150; 1879-1484; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2024.117616

Atherosclerosis manifests itself differently in men and women with respect to plaque initiation, progression and plaque composition. The observed delay in plaque progression in women is thought to be related to the hormonal status of women. Also features associated with the vulnerability of plaques to rupture seem to be less frequently present in women compared to men. Current invasive and non-invasive imaging modalities allow for visualization of plaque size, composition and high risk vulnerable plaque features. Moreover, image based modeling gives access to local shear stress and shear stress-related plaque growth. In this review, current knowledge on sex-related differences in plaque size, composition, high risk plaque features and shear stress related plaque growth in carotid and coronary arteries obtained from imaging are summarized. [Display omitted] •(Non)-invasive imaging allows for visualization of plaque size and composition in coronary and carotid arteries.•Marked differences in plaque size and composition are reported between men and women, which vary with age and clinical status.•Plaques observed in carotid arteries from women show less frequent vulnerable plaque features compared to men.•Non-culprit lesions in coronary arteries in women are less vulnerable compared to men based on lipid content and cap thickness.•Culprit lesions in coronary arteries in women are similar in relative plaque composition to those in men.