Gender differences in coronary plaque components in patients with acute coronary syndrome: virtual histology-intravascular ultrasound analysis.
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.
Hong
Young Joon
YJ
Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Republic of Korea.
Jeong
Myung Ho
MH
Choi
Yun Ha
YH
Ma
Eun Hae
EH
Cho
Sook Hee
SH
Ko
Jum Suk
JS
Lee
Min Goo
MG
Park
Keun Ho
KH
Sim
Doo Sun
DS
Yoon
Nam Sik
NS
Youn
Hyun Ju
HJ
Kim
Kye Hun
KH
Park
Hyung Wook
HW
Kim
Ju Han
JH
Ahn
Youngkeun
Y
Cho
Jeong Gwan
JG
Park
Jong Chun
JC
Kang
Jung Chaee
JC
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
D002097:C-Reactive Protein