Gender differences in coronary plaque characteristics in patients with stable angina: a virtual histology
Fumitaka Inoue1, Soichi Yamaguchi, Kazuhiro Ueshima
1Department of Cardiology, Nara Prefectural Nara Hospital, 1-30-1 Hiramatsu, Nara, Nara, 631-0846, Japan, kennara@m3.kcn.ne.jp.
Insights
This study found significant differences in coronary plaque composition between female and male patients with stable angina. Female patients exhibited higher dense-calcium and necrotic core percentages, suggesting distinct plaque vulnerability.
Area of Science:
- Cardiology
- Vascular Ultrasound Imaging
Background:
- Stable angina affects both male and female patients, but underlying coronary plaque characteristics may differ.
- Understanding these differences is crucial for targeted therapeutic strategies and risk stratification.
Purpose of the Study:
- To compare culprit coronary plaque characteristics between female and male patients diagnosed with stable angina.
- To investigate potential associations between coronary risk factors and observed plaque composition differences.
Main Methods:
- Utilized virtual histology intravascular ultrasound (VH-IVUS) in 364 patients (72 female, 292 male) undergoing percutaneous coronary intervention (PCI).
- Analyzed plaque composition, including fibrous (FI), fibro-fatty (FF), dense-calcium (DC), and necrotic core (NC) percentages.
- Compared baseline characteristics and VH-IVUS results between female and male cohorts.
Main Results:
- Female patients presented with higher HbA1c, total cholesterol, and LDL-cholesterol levels compared to males.
- Fibrous (FI) and fibro-fatty (FF) plaque ratios were lower in females, while dense-calcium (DC) and necrotic core (NC) ratios were higher.
- Statistically significant differences were observed in plaque composition (p < 0.05 for all).
Conclusions:
- Coronary plaque composition in stable angina patients differs significantly between sexes.
- Higher proportions of dense-calcium and necrotic core in female patients may indicate increased plaque vulnerability.
- Observed differences in coronary risk factors likely contribute to distinct plaque characteristics in female versus male patients.
Abstract:
The purpose of this study was to compare culprit coronary plaque characteristics between female and male patients with stable angina using virtual histology intravascular ultrasound (VH-IVUS). The target population consisted of three hundred and sixty-four consecutive patients with stable angina who underwent percutaneous coronary intervention (PCI) after VH-IVUS. The baseline characteristics and VH-IVUS results were compared between 72 female and 292 male patients. Culprit coronary plaque histological composition ratios, which were classified as fibrous (FI)%, fibro-fatty (FF)%, dense-calcium (DC)% and necrotic core (NC)%, were evaluated by VH-IVUS. The HbA1c (6.4 ± 1.2% vs. 5.9 ± 1.0%, p < 0.0001), total cholesterol (202 ± 33 mg/dL vs. 189 ± 34 mg/dL, p = 0.004), and LDL-cholesterol (118 ± 32 mg/dL vs. 110 ± 27 mg/dL, p = 0.03) were higher in female patients compared to male patients. The FI ratio (55 ± 15% vs. 60 ± 15%, p = 0.02) and FF ratio (9 ± 8% vs. 12 ± 10%, p = 0.02) were lower, but the DC ratio (12 ± 13% vs. 9 ± 11%, p = 0.01) and NC ratio (23 ± 11% vs. 19 ± 12%, p = 0.02) were higher in female patients than in male patients. The differences in coronary risk factors between females and males may be associated with coronary plaque characteristics. Differences in culprit coronary plaque composition were observed between female and male patients with stable angina.
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