Quantitative coronary CT analysis reveals non-calcified atherosclerotic plaques in women with a history of pre-eclampsia

Abstract Aims A history of pre-eclampsia is associated with at least a two-fold increased risk of coronary artery disease (CAD), with unclear underlying mechanisms. This study aimed to investigate coronary plaque characteristics in women with a history of pre-eclampsia compared with women from the general population. Methods and results In this cross-sectional study, women with a history of pre-eclampsia from the Cardiovascular Riskprofile—Imaging and Gender-Specific Disorders (CREw-IMAGO) study (n = 138) were compared with a reference group of women without a self-reported history of pre-eclampsia from the Swedish Cardiopulmonary Bioimage study (SCAPIS, n = 390). All participants (age 45–55 years) underwent coronary computed tomography angiography (CCTA). Plaques were assessed quantitatively with semi-automated software for total, calcified, and non-calcified plaque volumes. Differences in plaque characteristics were analyzed using multivariable linear regression analyses. Women with a history of pre-eclampsia had a two-fold increased risk of having any coronary plaque. Among women with plaques, a history of pre-eclampsia was associated with a larger non-calcified plaque volume (beta: 0.62; 95% CI: 0.17–1.07) after adjustment for age, body mass index, education, dyslipidaemia, and a history of smoking. This was explained by larger volumes of fibrous plaque (beta: 0.71; 95% CI: 0.26–1.15) and fibrous fatty plaque (beta: 0.52; 95% CI: 0.01–1.03) and not due to a larger total plaque volume. Conclusion Women with a history of pre-eclampsia have coronary plaques with larger non-calcified plaque volume compared with unaffected women, driven by larger fibrous and fibrous fatty plaque volumes, independent of total plaque volume.