Mass General Brigham Study Finds Women Face Major Cardiac Risks at Lower Plaque Levels Than Men

Mass General Brigham study reveals women face heart attack risks at 20% plaque burden, compared to 28% in men, requiring new gender-specific diagnostic tools.

By: AXL Media

Published: Feb 24, 2026, 8:23 AM EST

Source: The information in this article was sourced from Mass General Brigham

Gender Specific Thresholds in Cardiovascular Assessment

Coronary artery disease remains the leading cause of mortality on a global scale, yet the clinical tools used to assess risk may not be equally calibrated for both sexes. A new study conducted by investigators at Mass General Brigham suggests that the traditional thresholds used to identify high risk patients often overlook the unique physiological trajectory of heart disease in women. According to the research, women tend to suffer from major adverse cardiovascular events (MACE) despite having a smaller total volume of arterial plaque. This finding challenges the conventional medical reliance on uniform metrics for diagnosing the severity of coronary obstructions.

An Analysis of Plaque Burden versus Volume

The investigative team utilized data from the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE), which encompassed 193 sites across North America. Using advanced cardiac computed tomography angiography, researchers measured both total plaque volume and total plaque burden (TPB), the latter representing the amount of plaque relative to the actual size of the blood vessel. According to lead author Jan Brendel, while women generally exhibited lower median plaque volumes, their vessel size adjusted plaque burden was comparable to men. This distinction is critical because it highlights that even a small amount of plaque can be highly obstructive in smaller female coronary vessels.

The Steep Escalation of Risk in Female Patients

The study identified a striking difference in how cardiovascular risk accumulates over time between the two groups. In women, the risk of experiencing a heart attack, death, or hospitalization for chest pain emerged at a plaque burden of approximately 20%. In contrast, men did not reach a similar risk profile until their plaque burden reached roughly 28%. According to the report, the risk for women increased much more steeply at these lower levels of arterial buildup, whereas the risk for men followed a more gradual upward trajectory. This suggests that the female cardiovascular system may be more sensitive to early stage arterial damage.