Cardiovascular Intervention and Therapeutics

, Volume 25, Issue 1, pp 40–45 | Cite as

Gender differences in coronary plaque characteristics in patients with stable angina: a virtual histology intravascular ultrasound study

  • Fumitaka Inoue
  • Soichi Yamaguchi
  • Kazuhiro Ueshima
  • Takatomi Fujimoto
  • Tadashi Kagoshima
  • Shiro Uemura
  • Yoshihiko Saito
Original Article
First Online:
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Accepted:

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.

Keywords

Coronary plaque Intravascular ultrasound Virtual histology 
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References

  1. 1.
    Welty FK. Women and cardiovascular risk. Am J Cardiol. 2001;88:48J–52J.CrossRefPubMedGoogle Scholar
  2. 2.
    Holmvang L, Mickey H. The effect of percutaneous coronary intervention in women with ischemic heart disease (article in Danish). Ugeskr Laeger. 2007;169:2437–9.PubMedGoogle Scholar
  3. 3.
    Presbitero P, Carcagni A. Gender differences in the outcome of interventional cardiac procedures. Ital Heart J. 2003;4:522–7.PubMedGoogle Scholar
  4. 4.
    Nair A, Kuban BD, Tuzcu EM, Schoenhagen P, Nissen SE, Vince DG. Coronary plaque classification with intravascular ultrasound radiofrequency data analysis. Circulation. 2002;106:2200–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Nair A, Calvetti D, Vince DG. Regularized autoregressive analysis of intravascular ultrasound backscatter: improvement in spatial accuracy of tissue maps. IEEE Trans Ultrason Ferroelectr Freq Control. 2004;51:420–31.CrossRefPubMedGoogle Scholar
  6. 6.
    Cowley MJ, Mullin SM, Kelsey SF, Kent KM, Gruentzig AR, Detre KM, et al. Sex differences in early and long-term results of coronary angioplasty in the NHLBI PTCA registry. Circulation. 1985;71:90–7.PubMedGoogle Scholar
  7. 7.
    Becker RC, Terrin M, Ross R, Knatterud GL, Desviqune-Nickens P, Gore JM, et al. Comparison of clinical outcomes for women and men after acute myocardial infarction. The thrombolysis in myocardial infarction investigators. Ann Intern Med. 1994;120:638–45.PubMedGoogle Scholar
  8. 8.
    Vaccarino V, Krumholz HM, Yarzebski J, Gore JM, Goldberg RJ. Sex differences in 2-year mortality after hospital discharge for myocardial infarction. Ann Intern Med. 2001;134:173–81.PubMedGoogle Scholar
  9. 9.
    Kosuge M, Kimura K, Kojima S, Sakamoto T, Ishihara M, Asada Y, et al. Sex differences in early mortality of patients undergoing primary stenting for acute myocardial infarction. Circ J. 2006;70:217–21.CrossRefPubMedGoogle Scholar
  10. 10.
    Mauther SL, Lin F, Mauther GC, Roberts WC. 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. 1993;21:1312–8.CrossRefGoogle Scholar
  11. 11.
    Kornowski R, Lansky AJ, Mintz GC, Kent KM, Pichard AD, Satler LF, et al. Comparison of men versus women in cross-sectional area luminal narrowing, quantity of plaque, presence of calcium in plaque, and lumen location in coronary arteries by intravascular ultrasound in patients with stable angina pectoris. Am J Cardiol. 1997;79:1601–5.CrossRefPubMedGoogle Scholar
  12. 12.
    Nair A, Kuban BD, Obuchowski N, Vince DG. Assessing spectral algorithms to predict atherosclerotic plaque composition with normalized and raw intravascular ultrasound data. Ultrasound Med Biol. 2001;27:1319–31.CrossRefPubMedGoogle Scholar
  13. 13.
    Virmani R, Burke AP, Farb A, Kolodgie FD. Pathology of the vulnerable plaque. J Am Coll Cardiol. 2006;47:C13–8.CrossRefPubMedGoogle Scholar
  14. 14.
    Kawaguchi R, Oshima S, Jingu M, Tsurugaya H, Toyama T, Hoshizaki H, et al. Usefulness of virtual histology intravascular ultrasound to predict distal embolization for ST-segment elevation myocardial infarction. J Am Coll Cardiol. 2007;50:1641–6.CrossRefPubMedGoogle Scholar
  15. 15.
    Hong MK, Mintz GS, Lee CW, Suh J, Kim JH, Park DW, et al. Comparison of virtual histology to intravascular ultrasound of culprit coronary lesions in acute coronary syndrome and target coronary lesions in stable angina pectoris. Am J Cardiol. 2007;100:953–9.CrossRefPubMedGoogle Scholar
  16. 16.
    Hausleiter J, Meyer T, Hadamitzky M, Kastrati A, Martinoff S, Schomig A. Prevalence of noncalcified coronary plaques by 64-slice computed tomography in patients with an intermediate risk for significant coronary artery disease. J Am Coll Cardiol. 2006;48:312–8.CrossRefPubMedGoogle Scholar
  17. 17.
    Colhoun HM, Rubens MB, Underwood SR, Fuller JH. The effect of type 1 diabetes mellitus on the gender difference in coronary artery calcification. J Am Coll Cardiol. 2000;36:2160–7.CrossRefPubMedGoogle Scholar
  18. 18.
    Nasu K, Tsuchikane E, Katoh O, Fujita H, Surmely JF, Ehara M, et al. Plaque characterization by virtual histology intravascular ultrasound analysis in type II diabetic patients. Heart. 2008;94:429–33.CrossRefPubMedGoogle Scholar
  19. 19.
    Akishita M, Ouchi Y, Miyoshi H, Kozaki K, Inoue S, Ishikawa M, et al. Estrogen inhibits cuff-induced intimal thickening of rat femoral artery. Effects on migration and proliferation of vascular smooth muscle cells. Atherosclerosis. 1997;130:1–10.CrossRefPubMedGoogle Scholar
  20. 20.
    Mendelsohn ME, Karas RH. The protective effects of estrogen on the cardiovascular system. N Engl J Med. 1999;340:1801–11.CrossRefPubMedGoogle Scholar
  21. 21.
    Parthasarathy S, Printz DJ, Boyd D, Joy L, Steinberg D. Macrophage oxidation of low density lipoprotein generates a modified form recognized by the scavenger receptor. Arteriosclerosis. 1986;6:505–10.PubMedGoogle Scholar

Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2010

Authors and Affiliations

  • Fumitaka Inoue
    • 1
  • Soichi Yamaguchi
    • 1
  • Kazuhiro Ueshima
    • 1
  • Takatomi Fujimoto
    • 1
  • Tadashi Kagoshima
    • 1
  • Shiro Uemura
    • 2
  • Yoshihiko Saito
    • 2
  1. 1.Department of CardiologyNara Prefectural Nara HospitalNaraJapan
  2. 2.First Department of Internal MedicineNara Medical UniversityNaraJapan

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