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Coronary Computed Tomography Angiography: Enhancing Risk Stratification and Diagnosis of Cardiovascular Disease in Women

  • Imaging (Q Truong, Section Editor)
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Abstract

Purpose of review

There are numerous gender- and sex-based differences that contribute to the increased morbidity and mortality related to atherosclerotic cardiovascular disease (ASCVD) in women. Early detection of risk and targeted management of atherosclerotic disease is fundamental to reduce ASCVD risk and improve outcomes in women. In this review, we examine the utility of cardiac computed tomography (CT) and coronary CT angiography (CTA) in three ASCVD scenarios including coronary artery calcium scoring for risk stratification in asymptomatic women, and coronary CTA for diagnosis and prognosis of stable ischemic heart disease and acute chest pain. The risks of radiation exposure and the potential applications of novel technologies in women are explored.

Recent findings

CTA provides the capabilities of early recognition and management of nonobstructive coronary artery disease (CAD). Recent advancements in plaque composition and morphology further enhance the prognostic yield from coronary CTA. Innovations in stress perfusion and computational fluid dynamics allow for evaluation of physiological measures of ischemia. In addition, developments in artificial intelligence (AI) may also help unlock a deeper understanding of atherosclerosis and risk in women.

Summary

Coronary CTA is an accurate and useful modality for early detection and management of ASCVD in women. Novel technologies hold great promise for furthering our understanding of sex-specific pathophysiology and potential improvement in clinical management and outcomes.

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  1. Department of Cardiovascular Medicine, Beaumont Health-Royal Oak, 3601 West 13 Mile Road, Royal Oak, MI, 48073, USA

    Sara Karnib MD & Kavitha M. Chinnaiyan MD, FACC, FSCCT

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  1. Sara Karnib MD
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Correspondence to Kavitha M. Chinnaiyan MD, FACC, FSCCT.

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Sara Karnib reports institutional grant support from Heartflow, Inc.

Kavitha M. Chinnaiyan reports institutional grant support from Heartflow, Inc. and is on the medical advisory board of Heartflow, Inc.

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Karnib, S., Chinnaiyan, K.M. Coronary Computed Tomography Angiography: Enhancing Risk Stratification and Diagnosis of Cardiovascular Disease in Women. Curr Treat Options Cardio Med 21, 62 (2019). https://doi.org/10.1007/s11936-019-0760-1

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