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

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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.

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Abbreviations

AMI:

Acute myocardial infarction

ACS:

Acute coronary syndrome

CSA:

Cross-sectional area

EEM:

External elastic membrane

IVUS:

Intravascular Ultrasound

MLA:

Minimal lumen area

PCI:

Percutaneous coronary intervention

P&M:

Plaque and media

QCA:

Quantitative coronary angiography

STEMI:

ST elevation myocardial infarction

TCFA:

Thin-cap fibroatheroma

TIMI:

Thrombolysis In Myocardial Infarction

VH-IVUS:

Virtual-Histology Intravascular Ultrasound

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    Authors and Affiliations

    1. Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, Ulsan, 682-714, South Korea

      Soe Hee Ann, Gillian Balbir Singh, Kyung Hun Lim & Eun-Seok Shin

    2. Department of Cardiology, Dong-A University Hospital, Busan, South Korea

      Cai De Jin & Moo Hyun Kim

    3. College of Medicine, Yeungnam University, Daegu, South Korea

      Jae-Wook Chung

    4. East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, UK

      Scot Garg

    5. Department of Cardiology, Chung-Ang University Hospital, Heukseok-dong, Dongjak-gu, 156-755, Seoul, South Korea

      Wang-Soo Lee & Sang Wook Kim

    6. Department of Cardiology, Kosin University School of Medicine, Busan, South Korea

      Kyoung Im Cho

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    1. Soe Hee Ann
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    Correspondence to Sang Wook Kim or Eun-Seok Shin.

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    E.-S. Shin and S. W. Kim equally contributed to this article as correspondence.

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    Ann, S.H., De Jin, C., Singh, G.B. et al. Gender differences in plaque characteristics of culprit lesions in patients with ST elevation myocardial infarction. Heart Vessels 31, 1767–1775 (2016). https://doi.org/10.1007/s00380-016-0806-1

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