nach oben

Erschienen in:

13.02.2016 | Original Article

Gender differences in plaque characteristics of culprit lesions in patients with ST elevation myocardial infarction

verfasst von: Soe Hee Ann, Cai De Jin, Gillian Balbir Singh, Kyung Hun Lim, Jae-Wook Chung, Scot Garg, Moo Hyun Kim, Wang-Soo Lee, Kyoung Im Cho, Sang Wook Kim, Eun-Seok Shin

Erschienen in: Heart and Vessels | Ausgabe 11/2016

Einloggen, um Zugang zu erhalten

Abstract

There is limited research on plaque characteristics of ST elevation myocardial infarction (STEMI) patients according to the gender and age. 280 Consecutive STEMI patients who underwent VH-IVUS imaging on culprit before percutaneous coronary intervention (PCI) were enrolled in this study. Women were significantly older than men (69.8 ± 10 vs. 55.9 ± 11.3, p < 0.001). After propensity matching, men had higher plaque burden (79.7 ± 7.8 vs. 73.7 ± 13.0 %, p = 0.010), more fibro-fatty tissue (12.8 ± 9.9 vs. 9.5 ± 6.8 %, p = 0.04) and less dense calcium than women (8.4 ± 5.8 vs. 12.3 ± 8.7 %, p = 0.007). Subgroups dividing by 50, 65, 75 years old, plaque burden was higher in elderly men aged 66–75 years compared to the young men aged less than 50 (75.5 ± 9.2 vs. 68.4 ± 10.1 %, p = 0.012). And middle aged men ranged 51–65 years showed significantly more plaque burden at minimal lumen area site than matched aged women (77.5 ± 8.0 vs. 69.0 ± 17.6 %, p = 0.012). Elderly women aged 66–75 years showed significantly more necrotic core (28.6 ± 7.3 %) and dense calcium (14.9 ± 7.5 %) compared to all the younger or matched subgroups of men. These differences in plaque composition are blunted in the very elderly of men and women aged over 75 years. The findings may explain the gender differences in clinical prognosis in STEMI patients.

Falk E, Nakano M, Bentzon JF, Finn AV, Virmani R (2013) Update on acute coronary syndromes: the pathologists’ view. Eur Heart J 34:719–728CrossRefPubMed

Arbustini E, Dal Bello B, Morbini P, Burke AP, Bocciarelli M, Specchia G, Virmani R (1999) Plaque erosion is a major substrate for coronary thrombosis in acute myocardial infarction. Heart 82:269–272CrossRefPubMedPubMedCentral

Farb A, Burke AP, Tang AL, Liang TY, Mannan P, Smialek J, Virmani R (1996) Coronary plaque erosion without rupture into a lipid core. A frequent cause of coronary thrombosis in sudden coronary death. Circulation 93:1354–1363CrossRefPubMed

Burke AP, Virmani R, Galis Z, Haudenschild CC, Muller JE (2003) 34th Bethesda Conference: task force #2–What is the pathologic basis for new atherosclerosis imaging techniques? J Am Coll Cardiol 41:1874–1886CrossRefPubMed

Rodriguez-Granillo GA, Garcia-Garcia HM, Mc Fadden EP, Valgimigli M, Aoki J, de Feyter P, Serruys PW (2005) In vivo intravascular ultrasound-derived thin-cap fibroatheroma detection using ultrasound radiofrequency data analysis. J Am Coll Cardiol 46:2038–2042CrossRefPubMed

Nair A, Kuban BD, Tuzcu EM, Schoenhagen P, Nissen SE, Vince DG (2002) Coronary plaque classification with intravascular ultrasound radiofrequency data analysis. Circulation 106:2200–2206CrossRefPubMed

Fujii K, Mintz GS, Carlier SG, Costa J Jr, Kimura M, Sano K, Tanaka K, Costa RA, Lui J, Stone GW, Moses JW, Leon MB (2006) Intravascular ultrasound profile analysis of ruptured coronary plaques. Am J Cardiol 98:429–435CrossRefPubMed

Nasu K, Tsuchikane E, Katoh O, Vince DG, Virmani R, Surmely JF, Murata A, Takeda Y, Ito T, Ehara M, Matsubara T, Terashima M, Suzuki T (2006) Accuracy of in vivo coronary plaque morphology assessment: a validation study of in vivo virtual histology compared with in vitro histopathology. J Am Coll Cardiol 47:2405–2412CrossRefPubMed

Ruiz-Garcia J, Lerman A, Weisz G, Maehara A, Mintz GS, Fahy M, Xu K, Lansky AJ, Cristea E, Farah TG, Teles R, Botker HE, Templin B, Zhang Z, de Bruyne B, Serruys PW, Stone GW (2012) Age- and gender-related changes in plaque composition in patients with acute coronary syndrome: the PROSPECT study. EuroIntervention 8:929–938CrossRefPubMed

10.

Qian J, Maehara A, Mintz GS, Margolis MP, Lerman A, Rogers J, Banai S, Kazziha S, Castellanos C, Dani L, Fahy M, Stone GW, Leon MB (2009) Impact of gender and age on in vivo virtual histology-intravascular ultrasound imaging plaque characterization (from the global Virtual Histology Intravascular Ultrasound [VH-IVUS] registry). Am J Cardiol 103:1210–1214CrossRefPubMed

11.

Lee CW, Hwang I, Park CS, Lee H, Park DW, Kang SJ, Lee SW, Kim YH, Park SW, Park SJ (2013) Comparison of intravascular ultrasound and histological findings in culprit coronary plaques between ST-segment elevation and non-ST-segment elevation myocardial infarction. Am J Cardiol 112:68–72CrossRefPubMed

12.

Dong L, Mintz GS, Witzenbichler B, Metzger DC, Rinaldi MJ, Duffy PL, Weisz G, Stuckey TD, Brodie BR, Yun KH, Xu K, Kirtane AJ, Stone GW, Maehara A (2015) Comparison of Plaque Characteristics in Narrowings With ST-Elevation Myocardial Infarction (STEMI), Non-STEMI/Unstable Angina Pectoris and Stable Coronary Artery Disease (from the ADAPT-DES IVUS Substudy). Am J Cardiol 115:860–866CrossRefPubMed

13.

American College of Emergency Physicians, Society for Cardiovascular Angiography and Interventions, O’Gara PT, Kushner FG, Ascheim DD, Casey DE, Jr., Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Kushner FG, Ohman EM, Stevenson WG, Yancy CW (2013) 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 61:e78–e140

14.

Mintz GS, Nissen SE, Anderson WD, Bailey SR, Erbel R, Fitzgerald PJ, Pinto FJ, Rosenfield K, Siegel RJ, Tuzcu EM, Yock PG (2001) American College of Cardiology Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS). A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol 37:1478–1492CrossRefPubMed

15.

Schoenhagen P, Ziada KM, Kapadia SR, Crowe TD, Nissen SE, Tuzcu EM (2000) Extent and direction of arterial remodeling in stable versus unstable coronary syndromes: an intravascular ultrasound study. Circulation 101:598–603CrossRefPubMed

16.

Stone GW, Maehara A, Lansky AJ, de Bruyne B, Cristea E, Mintz GS, Mehran R, McPherson J, Farhat N, Marso SP (2011) A prospective natural-history study of coronary atherosclerosis. N Engl J Med 364:226–235CrossRefPubMed

17.

Lansky AJ, Ng VG, Maehara A, Weisz G, Lerman A, Mintz GS, De Bruyne B, Farhat N, Niess G, Jankovic I, Lazar D, Xu K, Fahy M, Serruys PW, Stone GW (2012) Gender and the extent of coronary atherosclerosis, plaque composition, and clinical outcomes in acute coronary syndromes. JACC Cardiovasc Imaging 5:S62–S72CrossRefPubMed

18.

Corrada E, Ferrante G, Mazzali C, Barbieri P, Merlino L, Merlini P, Presbitero P (2014) Eleven-year trends in gender differences of treatments and mortality in ST-elevation acute myocardial infarction in northern Italy, 2000–2010. Am J Cardiol 114:336–341CrossRefPubMed

19.

Lansky AJ, Pietras C, Costa RA, Tsuchiya Y, Brodie BR, Cox DA, Aymong ED, Stuckey TD, Garcia E, Tcheng JE, Mehran R, Negoita M, Fahy M, Cristea E, Turco M, Leon MB, Grines CL, Stone GW (2005) Gender differences in outcomes after primary angioplasty versus primary stenting with and without abciximab for acute myocardial infarction: results of the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) trial. Circulation 111:1611–1618CrossRefPubMed

20.

Leurent G, Garlantezec R, Auffret V, Hacot JP, Coudert I, Filippi E, Rialan A, Moquet B, Rouault G, Gilard M, Castellant P, Druelles P, Boulanger B, Treuil J, Avez B, Bedossa M, Boulmier D, Le Guellec M, Le Breton H (2014) Gender differences in presentation, management and inhospital outcome in patients with ST-segment elevation myocardial infarction: data from 5000 patients included in the ORBI prospective French regional registry. Arch Cardiovasc Dis 107:291–298CrossRefPubMed

21.

Milcent C, Dormont B, Durand-Zaleski I, Steg PG (2007) Gender differences in hospital mortality and use of percutaneous coronary intervention in acute myocardial infarction: microsimulation analysis of the 1999 nationwide French hospitals database. Circulation 115:833–839CrossRefPubMed

22.

Gevaert SA, De Bacquer D, Evrard P, Convens C, Dubois P, Boland J, Renard M, Beauloye C, Coussement P, De Raedt H, de Meester A, Vandecasteele E, Vranckx P, Sinnaeve PR, Claeys MJ (2014) Gender, TIMI risk score and in-hospital mortality in STEMI patients undergoing primary PCI: results from the Belgian STEMI registry. EuroIntervention 9:1095–1101CrossRefPubMed

23.

Otten AM, Maas AH, Ottervanger JP, Kloosterman A, van’t Hof AW, Dambrink JH, Gosselink AT, Hoorntje JC, Suryapranata H, de Boer MJ (2013) Is the difference in outcome between men and women treated by primary percutaneous coronary intervention age dependent? Gender difference in STEMI stratified on age. Eur Heart J Acute Cardiovasc Care 2:334–341CrossRefPubMedPubMedCentral

24.

Grundy SM (1994) Guidelines for cholesterol management: recommendations of the National Cholesterol Education Program’s Adult Treatment Panel II. Heart Dis Stroke 3:123–127PubMed

25.

Lerner DJ, Kannel WB (1986) Patterns of coronary heart disease morbidity and mortality in the sexes: a 26-year follow-up of the Framingham population. Am Heart J 111:383–390CrossRefPubMed

26.

Lakatta EG, Levy D (2003) Arterial and cardiac aging: major shareholders in cardiovascular disease enterprises: part I: aging arteries: a “set up” for vascular disease. Circulation 107:139–146CrossRefPubMed

27.

DeGeare VS, Stone GW, Grines L, Brodie BR, Cox DA, Garcia E, Wharton TP, Boura JA, O’Neill WW, Grines CL (2000) Angiographic and clinical characteristics associated with increased in-hospital mortality in elderly patients with acute myocardial infarction undergoing percutaneous intervention (a pooled analysis of the primary angioplasty in myocardial infarction trials). Am J Cardiol 86:30–34CrossRefPubMed

28.

Burke AP, Weber DK, Kolodgie FD, Farb A, Taylor AJ, Virmani R (2001) Pathophysiology of calcium deposition in coronary arteries. Herz 26:239–244CrossRefPubMed

29.

Ogura Y, Tsujita K, Shimomura H, Yamanaga K, Komura N, Miyazaki T, Ishii M, Tabata N, Akasaka T, Arima Y, Sakamoto K, Kojima S, Nakamura S, Kaikita K, Hokimoto S, Ogawa H (2014) Clinical characteristics and intravascular ultrasound findings of culprit lesions in elderly patients with acute coronary syndrome. Heart Vessels. doi:10.1007/s00380-014-0616-2 PubMed

30.

Hong YJ, Jeong MH, Ahn Y, Sim DS, Chung JW, Cho JS, Yoon NS, Yoon HJ, Moon JY, Kim KH, Park HW, Kim JH, Cho JG, Park JC, Kang JC (2008) Age-related differences in intravascular ultrasound findings in 1,009 coronary artery disease patients. Circ J 72:1270–1275CrossRefPubMed

31.

Burke AP, Farb A, Malcom G, Virmani R (2001) Effect of menopause on plaque morphologic characteristics in coronary atherosclerosis. Am Heart J 141:S58–S62CrossRefPubMed

32.

Dollar AL, Kragel AH, Fernicola DJ, Waclawiw MA, Roberts WC (1991) Composition of atherosclerotic plaques in coronary arteries in women less than 40 years of age with fatal coronary artery disease and implications for plaque reversibility. Am J Cardiol 67:1223–1227CrossRefPubMed

33.

Mautner SL, Lin F, Mautner GC, Roberts WC (1993) Comparison in women versus men of composition of atherosclerotic plaques in native coronary arteries and in saphenous veins used as aortocoronary conduits. J Am Coll Cardiol 21:1312–1318CrossRefPubMed

34.

Taylor AJ, Burke AP, O’Malley PG, Farb A, Malcom GT, Smialek J, Virmani R (2000) A comparison of the Framingham risk index, coronary artery calcification, and culprit plaque morphology in sudden cardiac death. Circulation 101:1243–1248CrossRefPubMed

35.

Titel: Gender differences in plaque characteristics of culprit lesions in patients with ST elevation myocardial infarction
verfasst von: Soe Hee Ann
Cai De Jin
Gillian Balbir Singh
Kyung Hun Lim
Jae-Wook Chung
Scot Garg
Moo Hyun Kim
Wang-Soo Lee
Kyoung Im Cho
Sang Wook Kim
Eun-Seok Shin
Publikationsdatum: 13.02.2016
Verlag: Springer Japan
Erschienen in: Heart and Vessels / Ausgabe 11/2016
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-016-0806-1

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Gender differences in plaque characteristics of culprit lesions in patients with ST elevation myocardial infarction

Abstract

Neu im Fachgebiet Kardiologie

Vorsicht, erhöhte Blutungsgefahr nach PCI!

Triglyzeridsenker schützt nicht nur Hochrisikopatienten

Gibt es eine Wende bei den bioresorbierbaren Gefäßstützen?

Darf man die Behandlung eines Neonazis ablehnen?

Update Kardiologie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2016

Global area strain is a sensitive marker of subendocardial damage in adults after optimal repair of aortic coarctation: three-dimensional speckle-tracking echocardiography data

Cardiac fibrosis detected by magnetic resonance imaging on predicting time course diversity of left ventricular reverse remodeling in patients with idiopathic dilated cardiomyopathy

Decellularized aortic conduits: could their cryopreservation affect post-implantation outcomes? A morpho-functional study on porcine homografts

Impact of catheter size on reliability of quantitative coronary angiographic measurements (comparison of 4Fr and 6Fr catheters)

Measurement of epicardial fat thickness by transthoracic echocardiography for predicting high-risk coronary artery plaques

Prognostic value of multiple biomarkers for cardiovascular mortality in adult congenital heart disease: comparisons of single-/two-ventricle physiology, and systemic morphologically right/left ventricles

Neu im Fachgebiet Kardiologie

Vorsicht, erhöhte Blutungsgefahr nach PCI!

Triglyzeridsenker schützt nicht nur Hochrisikopatienten

Gibt es eine Wende bei den bioresorbierbaren Gefäßstützen?

Darf man die Behandlung eines Neonazis ablehnen?

Update Kardiologie