Assessment with multi-slice computed tomography and gray-scale and virtual histology intravascular ultrasound of gender-specific differences in extent and composition of coronary atherosclerotic plaques in relation to age.
Data evaluating gender- and age-specific differences in plaque observations on multislice computed tomography (MSCT) are scarce. Accordingly, the aim of this study was to evaluate coronary plaque patterns in men and women in relation to age using MSCT. The findings were compared to observations on grayscale intravascular ultrasound (IVUS) and virtual histology (VH) IVUS. In total, 93 patients (59 men, 34 women) underwent 64-slice MSCT followed by conventional coronary angiography with IVUS. Plaque extent and composition were assessed on MSCT, grayscale IVUS, and VH IVUS. Coronary plaque patterns were compared between men and women in 2 age groups (<65 and >or=65 years old). In patients aged <65 years, more plaques were observed on MSCT in men (6 +/- 4 vs 2 +/- 2 in women, p <0.001). Also, a larger plaque burden was observed on grayscale IVUS in men (45.7 +/- 11.4% vs 36.3 +/- 11.6% in women, p <0.001). Similarly, more mixed plaques were observed in men (3 +/- 3 vs 1 +/- 1 in women, p = 0.003), whereas a larger arc of calcium was detected on grayscale IVUS in men (91.7 +/- 93.5 degrees vs 25.7 +/- 51.0 degrees in women, p <0.001). On VH IVUS, the prevalence of thin-cap fibroatheroma was higher in men (31% vs 0%) compared to women. In patients aged >or=65 years old, no important differences in plaque patterns were observed between men and women. In conclusion, more extensive atherosclerosis and more calcified lesions were observed in men than in women. These differences were predominantly present in patients aged <65 years and were lost in those aged >or=65 years.
Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Gabija
G
Pundziute
Joanne D
JD
Schuijf
Joella E
JE
van Velzen
J Wouter
JW
Jukema
Jacob M
JM
van Werkhoven
Gaetano
G
Nucifora
Frank
F
van der Kley
Lucia J
LJ
Kroft
Albert
A
de Roos
Eric
E
Boersma
Johan H C
JH
Reiber
Martin J
MJ
Schalij
Ernst E
EE
van der Wall
Jeroen J
JJ
Bax
D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D017678:Sex Distribution; D012737:Sex Factors; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional; D014584:User-Computer Interface