Culprit plaque characteristics in women vs men with a first ST-segment elevation myocardial infarction: In vivo optical coherence tomography insights.

Abstract

BACKGROUND:

It is unclear whether more severe coronary atherosclerosis is a prerequisite to an initial acute coronary event in women vs men.

HYPOTHESIS:

Women may have more severe coronary atherosclerosis than men in patients with acute coronary event.

METHODS:

We used intravascular optical coherence tomography (OCT) to evaluate gender differences in culprit-plaque morphology in patients with a first ST-segment elevation myocardial infarction (STEMI).We retrospectively enrolled 211 consecutive patients who experienced a first STEMI and underwent an OCT examination of their infarct-related artery before primary percutaneous coronary intervention.

RESULTS:

Of the 211 patients enrolled, 162 (76.7%) were men and 49 (23.2%) were women. The women were significantly older than the men (mean age, 60.2 ± 8.2 vs 55.7 ± 11.2 years; P = 0.01) and less likely to be current smokers (P = 0.02). Moreover, the delay from symptom onset to reperfusion was longer in women than in men (7.6 ± 6.1 vs 5.5 ± 4.4 hours; P = 0.01). The OCT data indicated that there were no gender differences in culprit-plaque morphology, including lipid length, lipid arc, minimum fibrous cap thickness, or minimum lumen area. Additionally, no gender differences were found in the prevalence of plaque rupture, thin-cap fibroatheroma, residual thrombus, microvessels, macrophages, cholesterol crystals, or calcification.

CONCLUSIONS:

Among patients presenting with a first STEMI, there were no differences in culprit plaque features between women and men.

• Authors: Rong Sun, Liping Sun, Yandong Fu, Huimin Liu, Maoen Xu, Xuefeng Ren, Huai Yu, Hui Dong, Yang Liu, Yinchun Zhu, Jinwei Tian, Bo Yu
• Journal: Clinical cardiology (Clin Cardiol) Vol. 40 Issue 12 Pg. 1285-1290 (Dec 2017) ISSN: 1932-8737 [Electronic] United States
• PMID: 29247510 (Publication Type: Journal Article)
• Copyright: © 2017 Wiley Periodicals, Inc.

Topics

• Coronary Angiography
• Coronary Vessels (diagnostic imaging)
• Endovascular Procedures (methods)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Percutaneous Coronary Intervention
• Plaque, Atherosclerotic (complications, diagnostic imaging, surgery)
• Reproducibility of Results
• Retrospective Studies
• ST Elevation Myocardial Infarction (diagnosis, etiology, surgery)
• Severity of Illness Index
• Sex Factors
• Tomography, Optical Coherence (methods)