Tipos de placas ateroscleróticas em pacientes com e sem hipertensão arterial à angiotomografia coronária

Abstract

Background: Systemic hypertension (SH) is one of the main risk factors for coronary artery disease (CAD), as well as male gender. Differences in coronary lesions between hypertensive and normotensive patients in both sexes have not been clearly determined by coronary CT angiography (CCTA). Objective: To investigate the coronary atherosclerosis and plaque characteristics in subjects according to the presence or absence of SH in both sexes by CCTA. Methods: This prospective study evaluated the difference of effect of SH according to gender. 509 individuals were referred to CCTA for CAD diagnostic and risk stratification from November 2011 to December 2012 at Dante Pazzanese Institute of Cardiology. They were divided according to gender and to the presence (HT+) or absence (HT-) of SH. Results: HT+ women had higher age (62.3±10.2 vs 57.8±12.8, p=0.01). After adjustment for confounding factors, age and male gender were associated with high calcium score (≥100) and multivessel disease. Regarding CAD extent, both sexes in HT+ group had significant CAD, however, HT+ men had more often multivessel disease. SH was strongly associated with partially calcified plaque (OR=3.9). Conclusion: Hypertensive men had more often multivessel disease. Male gender was a preditor of significant CAD, multivessel disease, high calcium score and calcified and partially calcified plaques. However, hypertension was a predictor of partially calcified plaques.