Gender differences in plaque characteristics of culprit lesions in patients with ST elevation myocardial infarction |
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Authors: | 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 |
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Affiliation: | 1.Department of Cardiology,Ulsan University Hospital, University of Ulsan College of Medicine,Ulsan,South Korea;2.Department of Cardiology,Dong-A University Hospital,Busan,South Korea;3.College of Medicine,Yeungnam University,Daegu,South Korea;4.East Lancashire Hospitals NHS Trust,Blackburn,UK;5.Department of Cardiology,Chung-Ang University Hospital,Seoul,South Korea;6.Department of Cardiology,Kosin University School of Medicine,Busan,South Korea |
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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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