• Langue : Anglais
• Discipline : Médecine. Chirurgie vasculaire
• Identifiant : 2022ULILM309
• Type de thèse : Doctorat de médecine
• Date de soutenance : 30/09/2022

Résumé en langue originale

Introduction: Clinical assessment of cardiovascular risk in postmenopausal women is still challenging. The aim of this study is to evaluate the efficacy of the coronary computed tomography angiography to improve cardiovascular risk stratification in postmenopausal women. Methods: We included postmenopausal unselected women who referred for a cardiovascular evaluation at Lille University Hospital, in primary or secondary CVD prevention, who underwent a CCTA, between January 1, 2013 and March 31, 2021. They were classified in three group according to the CADRADS. Results: We included 151 postmenopausal women with a mean age of 58 years-old. According to ESC SCORE, 42% were at moderate risk, 46% at high risk, and 6% at very high risk of CVD. According to SCORE 2, 54% were at low risk, and 34% at moderate risk of CVD. A coronary artery atherosclerotic disease (CAD) was detected in 53% women, which was obstructive in 9% of cases. Women with a CAD were significantly more likely to have high CAC score, dyslipidaemia, a peripheral atherosclerosis and to be older. CCTA improved risk stratification and permitted to reclassify appropriately 23 % and 46% of our patients to a higher risk group compared to ESC and SCORE 2 scores respectively. Conclusion: Our findings suggested that traditional methods underestimate CVD risk in postmenopausal women. CCTA might be a tool of choice to improve CVD risk and to guide primary prevention therapies in this population.