title: Gender differences in coronary plaque components in patients with acute coronary syndrome: virtual histology-intravascular ultrasound analysis.
abstract: BACKGROUND
  The aim of this study was to evaluate the gender differences in plaque components in acute coronary syndrome (ACS) patients.
  
  
  METHODS
  We used virtual histology-intravascular ultrasound to evaluate the plaque components in culprit lesions in 362 ACS patients (254 men, 108 women).
  
  
  RESULTS
  Women were more likely to be diabetic (34% vs 23%, p=0.030), had greater percentage necrotic core (%NC) volume (19.0±12.7% vs 16.8±11.9%, p=0.040), and had trends toward higher high-sensitivity C-reactive protein (hs-CRP) (0.85±1.28 mg/dl vs 0.53±0.48 mg/dl, p=0.063), and higher incidence of thin-cap fibroatheroma (TCFA) (62% vs 52%, p=0.078) compared with men. %NC volume was significantly greater in diabetic patients compared with nondiabetic patients (20.4±10.2% vs 16.0±8.9%, p<0.001) and was significantly greater in patients with elevated hs-CRP (≥0.2 mg/dl) compared with those with normal hs-CRP (<0.2 mg/dl) (18.8±8.9% vs 16.6±9.7%, p=0.021). However, there were no differences in plaque components between diabetic women and men, and between women and men with elevated hs-CRP levels. Diabetes [odds ratio (OR): 2.44, 95% confidence interval (CI): 1.35-3.82, p=0.003] and hs-CRP (OR: 1.54, 95% CI: 1.08-2.65, p=0.032), but not female gender, were the independent predictors of TCFA.
  
  
  CONCLUSIONS
  Although it seems likely that female ACS patients have more vulnerable plaque components compared with male ACS patients, these findings may result not from true gender differences in plaque components but higher prevalence of diabetes and hs-CRP elevation in women.
authors.affiliation: Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Republic of Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Yun Ha
authors.initials: YH
authors.lastname: Choi
authors.forename: Eun Hae
authors.initials: EH
authors.lastname: Ma
authors.forename: Sook Hee
authors.initials: SH
authors.lastname: Cho
authors.forename: Jum Suk
authors.initials: JS
authors.lastname: Ko
authors.forename: Min Goo
authors.initials: MG
authors.lastname: Lee
authors.forename: Keun Ho
authors.initials: KH
authors.lastname: Park
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.forename: Nam Sik
authors.initials: NS
authors.lastname: Yoon
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Youn
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology*; D002097:C-Reactive Protein / Q000032:analysis; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology*; D048909:Diabetes Complications; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D002097:C-Reactive Protein