In-vivo comparison of coronary plaque characteristics using optical coherence tomography in women vs. men with acute coronary syndrome.
OBJECTIVE
Women with acute coronary syndromes (ACS) have worse outcomes than men. Data on sex differences of culprit plaque characteristics are lacking. Intravascular optical coherence tomography (OCT) is a high-resolution imaging technique capable of in-vivo plaque characterization. The aim of this study was to compare culprit plaque characteristics in women and men presenting with ACS.


METHODS
Patients undergoing coronary angiography after ACS were enrolled. We performed OCT imaging on the culprit lesions. Previously validated criteria for OCT plaque characterization were used: lipid was quantified on cross-sectional image and lipid-rich plaque was defined as > or = 2 involved quadrants; fibrous cap thickness was measured at the thinnest point and thin-cap fibroatheroma was defined as lipid-rich plaque with fibrous cap thickness less than 65 microm.


RESULTS
Forty-two patients (33 men and nine women) were included. No significant sex differences were found in baseline characteristics. Lipid-rich plaques were identified in majority of patients. No significant difference, however, was seen in the frequency of lipid-rich plaques, thin-cap fibroatheroma or minimum fibrous cap thickness (79 vs. 89%; 45 vs. 67%; 53.8 vs. 45.4 microm, respectively; P=NS) between men and women. Incidence of calcification, thrombus and plaque disruption were also similar.


CONCLUSIONS
No significant sex difference was seen in culprit plaque characteristics determined by OCT imaging in patients who presented with ACS.
Chia
Stanley
S
Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Christopher Raffel
O
O
Takano
Masamichi
M
Tearney
Guillermo J
GJ
Bouma
Brett E
BE
Jang
Ik-Kyung
IK
D054058:Acute Coronary Syndrome / Q000473:pathology*; D000368:Aged; D002114:Calcinosis / Q000473:pathology; D003324:Coronary Artery Disease / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012727:Sex Characteristics; D013927:Thrombosis / Q000473:pathology; D041623:Tomography, Optical Coherence