Gender differences in coronary plaque components in patients with acute coronary syndrome: Virtual histology-intravascular ultrasound analysis

Summary Background The aim of this study was to evaluate the gender differences in plaque components in acute coronary syndrome (ACS) patients. Methods We used virtual histology-intravascular ultrasound to evaluate the plaque components in culprit lesions in 362 ACS patients (254 men, 108 women). Re...

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Veröffentlicht in:Journal of cardiology 2010-09, Vol.56 (2), p.211-219
Hauptverfasser: Hong, Young Joon, MD, Jeong, Myung Ho, MD, PhD, Choi, Yun Ha, RN, Ma, Eun Hae, RN, Cho, Sook Hee, RN, Ko, Jum Suk, MD, Lee, Min Goo, MD, Park, Keun Ho, MD, Sim, Doo Sun, MD, Yoon, Nam Sik, MD, Youn, Hyun Ju, MD, Kim, Kye Hun, MD, Park, Hyung Wook, MD, Kim, Ju Han, MD, Ahn, Youngkeun, MD, Cho, Jeong Gwan, MD, Park, Jong Chun, MD, Kang, Jung Chaee, MD
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container_end_page 219
container_issue 2
container_start_page 211
container_title Journal of cardiology
container_volume 56
creator Hong, Young Joon, MD
Jeong, Myung Ho, MD, PhD
Choi, Yun Ha, RN
Ma, Eun Hae, RN
Cho, Sook Hee, RN
Ko, Jum Suk, MD
Lee, Min Goo, MD
Park, Keun Ho, MD
Sim, Doo Sun, MD
Yoon, Nam Sik, MD
Youn, Hyun Ju, MD
Kim, Kye Hun, MD
Park, Hyung Wook, MD
Kim, Ju Han, MD
Ahn, Youngkeun, MD
Cho, Jeong Gwan, MD
Park, Jong Chun, MD
Kang, Jung Chaee, MD
description Summary Background The aim of this study was to evaluate the gender differences in plaque components in acute coronary syndrome (ACS) patients. Methods We used virtual histology-intravascular ultrasound to evaluate the plaque components in culprit lesions in 362 ACS patients (254 men, 108 women). Results Women were more likely to be diabetic (34% vs 23%, p = 0.030), had greater percentage necrotic core (%NC) volume (19.0 ± 12.7% vs 16.8 ± 11.9%, p = 0.040), and had trends toward higher high-sensitivity C-reactive protein (hs-CRP) (0.85 ± 1.28 mg/dl vs 0.53 ± 0.48 mg/dl, p = 0.063), and higher incidence of thin-cap fibroatheroma (TCFA) (62% vs 52%, p = 0.078) compared with men. %NC volume was significantly greater in diabetic patients compared with nondiabetic patients (20.4 ± 10.2% vs 16.0 ± 8.9%, p < 0.001) and was significantly greater in patients with elevated hs-CRP (≥0.2 mg/dl) compared with those with normal hs-CRP (
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Methods We used virtual histology-intravascular ultrasound to evaluate the plaque components in culprit lesions in 362 ACS patients (254 men, 108 women). Results Women were more likely to be diabetic (34% vs 23%, p = 0.030), had greater percentage necrotic core (%NC) volume (19.0 ± 12.7% vs 16.8 ± 11.9%, p = 0.040), and had trends toward higher high-sensitivity C-reactive protein (hs-CRP) (0.85 ± 1.28 mg/dl vs 0.53 ± 0.48 mg/dl, p = 0.063), and higher incidence of thin-cap fibroatheroma (TCFA) (62% vs 52%, p = 0.078) compared with men. %NC volume was significantly greater in diabetic patients compared with nondiabetic patients (20.4 ± 10.2% vs 16.0 ± 8.9%, p &lt; 0.001) and was significantly greater in patients with elevated hs-CRP (≥0.2 mg/dl) compared with those with normal hs-CRP (&lt;0.2 mg/dl) (18.8 ± 8.9% vs 16.6 ± 9.7%, p = 0.021). However, there were no differences in plaque components between diabetic women and men, and between women and men with elevated hs-CRP levels. Diabetes [odds ratio (OR): 2.44, 95% confidence interval (CI): 1.35–3.82, p = 0.003] and hs-CRP (OR: 1.54, 95% CI: 1.08–2.65, p = 0.032), but not female gender, were the independent predictors of TCFA. Conclusions Although it seems likely that female ACS patients have more vulnerable plaque components compared with male ACS patients, these findings may result not from true gender differences in plaque components but higher prevalence of diabetes and hs-CRP elevation in women.</description><identifier>ISSN: 0914-5087</identifier><identifier>EISSN: 1876-4738</identifier><identifier>DOI: 10.1016/j.jjcc.2010.05.009</identifier><identifier>PMID: 20599357</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Acute Coronary Syndrome - diagnostic imaging ; Acute Coronary Syndrome - pathology ; C-Reactive Protein - analysis ; Cardiovascular ; Coronary Angiography ; Coronary disease ; Coronary Vessels - diagnostic imaging ; Coronary Vessels - pathology ; Diabetes Complications ; Endosonography ; Female ; Gender ; Humans ; Male ; Middle Aged ; Plaque ; Ultrasonics</subject><ispartof>Journal of cardiology, 2010-09, Vol.56 (2), p.211-219</ispartof><rights>Japanese College of Cardiology</rights><rights>2010 Japanese College of Cardiology</rights><rights>Copyright © 2010 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c507t-abd7f927309287e2ea2c0738ff33ce94e7e375427256cff122442bef56cb37c3</citedby><cites>FETCH-LOGICAL-c507t-abd7f927309287e2ea2c0738ff33ce94e7e375427256cff122442bef56cb37c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jjcc.2010.05.009$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20599357$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hong, Young Joon, MD</creatorcontrib><creatorcontrib>Jeong, Myung Ho, MD, PhD</creatorcontrib><creatorcontrib>Choi, Yun Ha, RN</creatorcontrib><creatorcontrib>Ma, Eun Hae, RN</creatorcontrib><creatorcontrib>Cho, Sook Hee, RN</creatorcontrib><creatorcontrib>Ko, Jum Suk, MD</creatorcontrib><creatorcontrib>Lee, Min Goo, MD</creatorcontrib><creatorcontrib>Park, Keun Ho, MD</creatorcontrib><creatorcontrib>Sim, Doo Sun, MD</creatorcontrib><creatorcontrib>Yoon, Nam Sik, MD</creatorcontrib><creatorcontrib>Youn, Hyun Ju, MD</creatorcontrib><creatorcontrib>Kim, Kye Hun, MD</creatorcontrib><creatorcontrib>Park, Hyung Wook, MD</creatorcontrib><creatorcontrib>Kim, Ju Han, MD</creatorcontrib><creatorcontrib>Ahn, Youngkeun, MD</creatorcontrib><creatorcontrib>Cho, Jeong Gwan, MD</creatorcontrib><creatorcontrib>Park, Jong Chun, MD</creatorcontrib><creatorcontrib>Kang, Jung Chaee, MD</creatorcontrib><title>Gender differences in coronary plaque components in patients with acute coronary syndrome: Virtual histology-intravascular ultrasound analysis</title><title>Journal of cardiology</title><addtitle>J Cardiol</addtitle><description>Summary Background The aim of this study was to evaluate the gender differences in plaque components in acute coronary syndrome (ACS) patients. Methods We used virtual histology-intravascular ultrasound to evaluate the plaque components in culprit lesions in 362 ACS patients (254 men, 108 women). Results Women were more likely to be diabetic (34% vs 23%, p = 0.030), had greater percentage necrotic core (%NC) volume (19.0 ± 12.7% vs 16.8 ± 11.9%, p = 0.040), and had trends toward higher high-sensitivity C-reactive protein (hs-CRP) (0.85 ± 1.28 mg/dl vs 0.53 ± 0.48 mg/dl, p = 0.063), and higher incidence of thin-cap fibroatheroma (TCFA) (62% vs 52%, p = 0.078) compared with men. %NC volume was significantly greater in diabetic patients compared with nondiabetic patients (20.4 ± 10.2% vs 16.0 ± 8.9%, p &lt; 0.001) and was significantly greater in patients with elevated hs-CRP (≥0.2 mg/dl) compared with those with normal hs-CRP (&lt;0.2 mg/dl) (18.8 ± 8.9% vs 16.6 ± 9.7%, p = 0.021). However, there were no differences in plaque components between diabetic women and men, and between women and men with elevated hs-CRP levels. Diabetes [odds ratio (OR): 2.44, 95% confidence interval (CI): 1.35–3.82, p = 0.003] and hs-CRP (OR: 1.54, 95% CI: 1.08–2.65, p = 0.032), but not female gender, were the independent predictors of TCFA. 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Methods We used virtual histology-intravascular ultrasound to evaluate the plaque components in culprit lesions in 362 ACS patients (254 men, 108 women). Results Women were more likely to be diabetic (34% vs 23%, p = 0.030), had greater percentage necrotic core (%NC) volume (19.0 ± 12.7% vs 16.8 ± 11.9%, p = 0.040), and had trends toward higher high-sensitivity C-reactive protein (hs-CRP) (0.85 ± 1.28 mg/dl vs 0.53 ± 0.48 mg/dl, p = 0.063), and higher incidence of thin-cap fibroatheroma (TCFA) (62% vs 52%, p = 0.078) compared with men. %NC volume was significantly greater in diabetic patients compared with nondiabetic patients (20.4 ± 10.2% vs 16.0 ± 8.9%, p &lt; 0.001) and was significantly greater in patients with elevated hs-CRP (≥0.2 mg/dl) compared with those with normal hs-CRP (&lt;0.2 mg/dl) (18.8 ± 8.9% vs 16.6 ± 9.7%, p = 0.021). However, there were no differences in plaque components between diabetic women and men, and between women and men with elevated hs-CRP levels. Diabetes [odds ratio (OR): 2.44, 95% confidence interval (CI): 1.35–3.82, p = 0.003] and hs-CRP (OR: 1.54, 95% CI: 1.08–2.65, p = 0.032), but not female gender, were the independent predictors of TCFA. Conclusions Although it seems likely that female ACS patients have more vulnerable plaque components compared with male ACS patients, these findings may result not from true gender differences in plaque components but higher prevalence of diabetes and hs-CRP elevation in women.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>20599357</pmid><doi>10.1016/j.jjcc.2010.05.009</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Acute Coronary Syndrome - diagnostic imaging
Acute Coronary Syndrome - pathology
C-Reactive Protein - analysis
Cardiovascular
Coronary Angiography
Coronary disease
Coronary Vessels - diagnostic imaging
Coronary Vessels - pathology
Diabetes Complications
Endosonography
Female
Gender
Humans
Male
Middle Aged
Plaque
Ultrasonics
title Gender differences in coronary plaque components in patients with acute coronary syndrome: Virtual histology-intravascular ultrasound analysis
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