- Background and aims
The burden of coronary atherosclerosis differs between men and women. Beyond traditional cardiovascular risk factors, inflammatory biomarkers can influence plaque progression. We analyzed the influence of sex on coronary atherosclerosis and inflammatory cytokines.
Methods and results
Coronary CT angiography was performed in 301 patients and the extent of coronary atherosclerosis was assessed using semi-automated software. We analyzed total (TPV), non-calcified (NCPV), calcified (CPV) and low-density plaque volume in mm3. Serum was analyzed for various cytokines. Out of 301 patients, 94 (31 %) were female and 207 (69 %) were male. Significant differences were seen between women and men respectively for age, BMI and smoking status (all p < 0.05). All plaque types showed significantly higher volumes in men as compared to women (all p < 0.05). In men, significantly lower serum levels for IL-2 (3.2vs.4.3; p = 0.01) and interferon-gamma (3.2vs.8.8; p < 0.001) butBackground and aims
The burden of coronary atherosclerosis differs between men and women. Beyond traditional cardiovascular risk factors, inflammatory biomarkers can influence plaque progression. We analyzed the influence of sex on coronary atherosclerosis and inflammatory cytokines.
Methods and results
Coronary CT angiography was performed in 301 patients and the extent of coronary atherosclerosis was assessed using semi-automated software. We analyzed total (TPV), non-calcified (NCPV), calcified (CPV) and low-density plaque volume in mm3. Serum was analyzed for various cytokines. Out of 301 patients, 94 (31 %) were female and 207 (69 %) were male. Significant differences were seen between women and men respectively for age, BMI and smoking status (all p < 0.05). All plaque types showed significantly higher volumes in men as compared to women (all p < 0.05). In men, significantly lower serum levels for IL-2 (3.2vs.4.3; p = 0.01) and interferon-gamma (3.2vs.8.8; p < 0.001) but higher levels for MCP-1 (224vs.155; p < 0.001) were seen. In regression analysis, interferon-gamma - but not IL-2 or MCP-1 - showed significant inverse association with male sex (OR 0.32; 95 %CI: 0.16–0.67; p = 0.002). Of note, interferon-gamma levels significantly differed according to high and low TPV in men (16.8vs.9.9; p < 0.001) but not in women (14.5vs. 8.9; p = 0.65).
Conclusion
In our cohort of individuals with suspected CAD undergoing coronary CTA, serum levels of interferon-gamma were significantly higher in women, in spite of a lower coronary plaque burden. Higher interferon-gamma levels were associated with higher plaque burden among men, but not in women, which suggests an influence of sex on the role of interferon-gamma in atherogenesis and atherosclerosis progression.
Graphical abstract
Graphical abstract demonstrating differences of total plaque volume (TPV) and interferon-gamma levels (IFN-gamma) between men and women (top image). Divided by the median total plaque volume, the bottom images demonstrate interferon-gamma levels within each sex group respectively.…
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