Abstract
Postmortem studies reported plaque erosion is frequent in young women. Recent in vivo studies failed to show age and sex differences in the plaque erosion prevalence. The aim of this study was to investigate the prevalence of plaque erosion by age and sex among acute coronary syndromes (ACS) patients. From 1699 ACS patients, 1083 with plaque erosion or rupture were analyzed. Patients were categorized as 5 age groups (≤ 50, 51–60, 61–70, 71–80, ≥ 81 years). Overall prevalence of plaque erosion was similar between males and females (p = 0.831). Males age ≤ 50 had higher (p = 0.018) and age 71–80 had lower (p = 0.006) prevalence of plaque erosion. Females age 61–70 had higher (p = 0.021) and age 71–80 had lower (p = 0.045) prevalence of plaque erosion. In advanced age groups (≥ 71 years), rupture was the dominant etiology in both sexes. In multivariate analysis of males, age ≤ 50 demonstrated a trend to increase (OR 1.418, 95% CI 0.961–2.093, p = 0.078) the erosion risk. Females age ≤ 70 independently increased (OR 2.138, 95% CI 1.249–3.661, p = 0.006) the risk for erosion. The prevalence of plaque erosion was similar between males and females. Plaque erosion risk was increased in the males age ≤ 50 and in the females age ≤ 70 among ACS patients.
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Acknowledgements
IK Jang’s research was supported by Mr. Michael and Mrs. Kathryn Park and by Mrs. Gill and Mr. Allan Gray. The authors thank Mr. Gregory Gheewalla for his edit.
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Supplementary Fig.
1 Representative OCT images of plaque erosion and plaque rupture. The OCT image was used to define the underlying pathology of ACS. (A) Plaque erosion was defined if a fibrous cap was intact and thrombus (**) was present at the culprit lesion. (B) Plaque rupture was defined if fibrous cap discontinuity was observed with cavity formation (arrowheads). ACS, acute coronary syndrome; OCT, optical coherence tomography. (JPEG 549 kb)
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Kim, H.O., Kim, C.J., Kim, W. et al. Relative risk of plaque erosion among different age and sex groups in patients with acute coronary syndrome. J Thromb Thrombolysis 49, 352–359 (2020). https://doi.org/10.1007/s11239-019-01969-9
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DOI: https://doi.org/10.1007/s11239-019-01969-9