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Sex differences in plaque characteristics by intravascular imaging in patients with coronary artery disease


Ten Haaf, Monique E; Rijndertse, Melissa; Cheng, Jin M; de Boer, Sanneke P M; Garcia-Garcia, Hector M; van Geuns, Robert-Jan M; Regar, Evelyn; Lenzen, Mattie J; Appelman, Yolande; Boersma, Eric (2017). Sex differences in plaque characteristics by intravascular imaging in patients with coronary artery disease. EuroIntervention, 13(3):320-328.

Abstract

AIMS: We aimed to study sex differences in coronary plaque burden and plaque composition in patients with coronary artery disease (CAD).
METHODS AND RESULTS: Virtual histology intravascular ultrasound (VH-IVUS) and near-infrared spectroscopy (NIRS) imaging of a non-culprit coronary artery was performed in 178 (23.5%) women and 581 (76.5%) men who underwent invasive management of stable angina pectoris (SAP) or acute coronary syndrome (ACS). Women were older and had a worse cardiovascular risk profile than men, but less extended angiographic coronary disease. Irrespective of the presenting diagnosis, women had lower VH-IVUS-derived plaque burden than men (38.1% vs. 40.5% in SAP, and 35.9% vs. 38.8% in ACS). Standardised (mean 211 vs. 263 mm3 in SAP, and 199 vs. 245 mm3 in ACS) total plaque volume was lower in women. Volumes of fibrous tissue, fibro-fatty tissue, necrotic core and dense calcium were also lower in women. NIRS-derived lipid core burden index (LCBI) was lower in women, in particular in SAP (mean LCBI in the worst 4 mm 220 vs. 240). The observed differences remained significant after adjustment for clinical characteristics.
CONCLUSIONS: Women had more favourable plaque characteristics than men, despite their worse risk profile. Long-term follow-up studies are required to evaluate the clinical consequences.

Abstract

AIMS: We aimed to study sex differences in coronary plaque burden and plaque composition in patients with coronary artery disease (CAD).
METHODS AND RESULTS: Virtual histology intravascular ultrasound (VH-IVUS) and near-infrared spectroscopy (NIRS) imaging of a non-culprit coronary artery was performed in 178 (23.5%) women and 581 (76.5%) men who underwent invasive management of stable angina pectoris (SAP) or acute coronary syndrome (ACS). Women were older and had a worse cardiovascular risk profile than men, but less extended angiographic coronary disease. Irrespective of the presenting diagnosis, women had lower VH-IVUS-derived plaque burden than men (38.1% vs. 40.5% in SAP, and 35.9% vs. 38.8% in ACS). Standardised (mean 211 vs. 263 mm3 in SAP, and 199 vs. 245 mm3 in ACS) total plaque volume was lower in women. Volumes of fibrous tissue, fibro-fatty tissue, necrotic core and dense calcium were also lower in women. NIRS-derived lipid core burden index (LCBI) was lower in women, in particular in SAP (mean LCBI in the worst 4 mm 220 vs. 240). The observed differences remained significant after adjustment for clinical characteristics.
CONCLUSIONS: Women had more favourable plaque characteristics than men, despite their worse risk profile. Long-term follow-up studies are required to evaluate the clinical consequences.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiovascular Surgery
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Atherosclerosis, Intravascular ultrasound, Near-infrared spectroscopy, Sex
Language:English
Date:20 June 2017
Deposited On:27 Dec 2017 15:04
Last Modified:19 Feb 2018 09:45
Publisher:Europa Digital and Publishing
ISSN:1774-024X
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.4244/EIJ-D-16-00361
PubMed ID:27867141

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