Erin D. Michos, M.D. Profile picture
Johns Hopkins Medicine. Associate Professor, Cardiology. Co-Editor in Chief @AJPCardio. #WomenHeartHealth #CardioObstetrics #cvPrev #echofirst She/her #BeKind

Jul 16, 2021, 6 tweets

Women are not smaller men! #Atherosclerosis genesis, progression & sequelae different in women. Plaque erosion causing ACS more common in women. Women have unique #SDOH, are undertreated with #cvPrev therapies & #GDMT, leads to worsening outcomes in women. @lesleejshaw #SCCT2021

Women’s CVD risk can be underestimated. Female specific risk enhancers help. #CAC if risk uncertain. Women have lower #CAC prevalence than men but prevalence increases after menopause. CAC when present confers greater risk of incident CVD in women than men. @lesleejshaw #SCCT2021

Prevalence of non-obstructive #CAD is higher in women but is prognostic of risk. @lesleejshaw #SCCT2021

High risk plaque is also more predictive in women. Non-obstructive CAD + low HU >4% of plaque burden increases risk of MI by nearly 7-fold. And not only are high risk features associated with events but they are also associated with ischemia. @lesleejshaw #SCCT2021

In ISCHEMIA trial, half the screen failures were women for having INOCA. Consider differential of causes for INOCA. In sum, atherosclerosis is unique in women. @lesleejshaw #SCCT2021

And a plug for a recent #YesCCT review article on this topic that I participated, led by @DrAnumMinhas with contributions by @Heart_SCCT members @armin_zadeh @AChoiHeart, about sex-specific plaque signature. #SCCT2021 link.springer.com/article/10.100…

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