OUTLINE

1. Background

Efforts have been made in Western countries over the past 30 years to develop systems that promote gender-specific medical care based on biological, medical and social differences between men and women. One such example is the publication of the Effectiveness-Based Guidelines for the Prevention of Cardiovascular Disease in Women by the American Heart Association. In Japan, however, evidence related to sex differences in medical care is scarce, and researchers have been citing data and concepts from overseas studies without any local evidence. Nevertheless, research studies to change this situation have been initiated recently. According to the “Study on Sex Differences that Influence the Onset and Aggravation of Cardiovascular Disease and Search for The Optimal Treatment” funded by the FY 2006-2007 Ministry of Health, Labour and Welfare Grants-in-aid for Scientific Research program (Comprehensive Research Project on Children and Family: H18-children-general-003), evidence for sex differences in medicine has started to accumulate, but is yet to reach a considerable level. Approaches to provide gender-specific treatment in Japan have been limited to the adoption of external changes, such as creating an environment that increases the ease of receiving medical care services for women. Especially in field of cardiovascular disorders, “efforts to accumulate evidence for gender-specific differences in diseases” have hardly been made. Therefore, it is vital to initiate comprehensive assessments of the impact of sex differences on the onset, progress and prognosis of cardiovascular diseases from a medical and social point of view, and develop evidence to promote countermeasures against cardiovascular diseases in our country.

Additionally, widespread use of multi-slice computed tomography (CT) apparatus in our country has led to a dramatic increase in the number of people who undergo coronary artery CT examination (due to suspected coronary artery disease or for screening) and medical checkup. However, despite its common inclusion in routine examinations, there is insufficient evidence to support its clinical application.

2. Objective

This multi-center NADESICO study assesses the indicators of stenosis of the coronary artery lumen and coronary arterial wall properties (including the presence/absence and size of plaques, calcification, and lipid content) during coronary artery CT examination with the aim of identifying factors specific to women when compared to men. Furthermore, the study also aims to elucidate the prognosis of coronary artery stenosis and calcification in women by following up with the cohort.

3. Study design

  Multicenter, prospective cohort study

4. Study population

 Men and women aged 50-74 years who have undergone plain coronary CT scanning and coronary CT angiography due to suspected coronary artery disease

5. Study period

 From the date of approval by the research ethics committee to March 2020.

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