| Jung-Hyun Choi, So-Yeon Choi, Seung-Jea Tahk, Myeong-Ho Yoon, Byoung-Joo Choi, Soo-Jin Kang, Zhen-Guo Zheng, Gyo-Seung Hwang, Joon-Han Shin |
Backgrounds: Much attention has been directed toward an influence of gender on clinical presentation of cardiovascular disease, but important gaps in the knowledge remain. Hypothesis: Is there any gender difference in the characteristics of atherosclerotic coronary plaque? To get answer, we compared women’s plaque characteristics with men’s one in intravascular ultrasound(IVUS) findings of coronary disease.
Methods: Patients with more than 50% stenosis on coronary angiogram were sequentially enrolled and underwent IVUS analysis for qualitative and quantitative assessments of lesion, and both proximal and distal reference segments were also analyzed for assessing vascular remodeling. To consider compounding factors, all patients were completely investigated to have any cardiovascular risk factors such as age, body mass index, presence of hypertension, diabetes, dyslipidemia, or history of smoking.
Results: 307 target lesions in 283 patients (75 women, mean age 62±10 years) were performed coronary angiography(CAG) and IVUS analysis. Women were older(p<0.01), had on increased frequency of hypertension (p<0.01), hypercholesterolemia(p<0.01) and smoking history(p<0.01), and had higher BMI (p=0.02) than men. Women were less likely to be presented initially with AMI than men(p<0.01). In IVUS study, When corrected for BSA, there were no differences in vessel, lumen and plaque area at both lesion and reference sites. However, women had significant smaller plaque burden at lesion (69±16% vs 74±15%, p=0.02) and had larger plaque burden at reference segment (mean of proximal and distal; 29±10% vs 26±10%, p=0.04) compared with men. The lesion length didn’t showed the difference in both gender (21±10㎜ vs 20±10㎜, p=0.73) Women were strongly associated with a lesser frequency of eccentric plaque(eccentric index≤0.5; 77% vs 85%, p=0.04) and more frequency of hard plaque(40% vs 27%, p=0.02). Women also had lower vascular remodeling index(0.85±0.18 vs 0.92±0.25, p=0.04) than men.
Conclusions: This gender difference of plaque might be related with gender difference of clinical presentation and outcome in coronary artery disease.
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