“…One possible reason is that the average age of the female patients in the MCAO group, who were mostly postmenopausal women, was 63 years. Previous studies have concluded that the tortuosity of the coronary artery increases in postmenopausal women, it may be raleted to age-related increase in sclerostin secretion [ 40 ]. It is known that estrogen has an anti-atherosclerotic effect [ 41 ], estrogen deficiency may cause greater increases in vessel length and tortuosity [ 42 ].…”