title: Gender differences in plaque characteristics of culprit lesions in patients with ST elevation myocardial infarction.
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.
authors.affiliation: Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, Ulsan, 682-714, South Korea.
authors.forename: Soe Hee
authors.initials: SH
authors.lastname: Ann
authors.affiliation: Department of Cardiology, Dong-A University Hospital, Busan, South Korea.
authors.forename: Cai
authors.initials: C
authors.lastname: De Jin
authors.affiliation: Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, Ulsan, 682-714, South Korea.
authors.forename: Gillian Balbir
authors.initials: GB
authors.lastname: Singh
authors.affiliation: Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, Ulsan, 682-714, South Korea.
authors.forename: Kyung Hun
authors.initials: KH
authors.lastname: Lim
authors.affiliation: College of Medicine, Yeungnam University, Daegu, South Korea.
authors.forename: Jae-Wook
authors.initials: JW
authors.lastname: Chung
authors.affiliation: East Lancashire Hospitals NHS Trust, Blackburn, Lancashire, UK.
authors.forename: Scot
authors.initials: S
authors.lastname: Garg
authors.affiliation: Department of Cardiology, Dong-A University Hospital, Busan, South Korea.
authors.forename: Moo Hyun
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Chung-Ang University Hospital, Heukseok-dong, Dongjak-gu, 156-755, Seoul, South Korea.
authors.forename: Wang-Soo
authors.initials: WS
authors.lastname: Lee
authors.affiliation: Department of Cardiology, Kosin University School of Medicine, Busan, South Korea.
authors.forename: Kyoung Im
authors.initials: KI
authors.lastname: Cho
authors.affiliation: Department of Cardiology, Chung-Ang University Hospital, Heukseok-dong, Dongjak-gu, 156-755, Seoul, South Korea. swivus@gmail.com.
authors.forename: Sang Wook
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwan-doro, Dong-gu, Ulsan, 682-714, South Korea. sesim1989@gmail.com.
authors.forename: Eun-Seok
authors.initials: ES
authors.lastname: Shin
mesh_terms: D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005355:Fibrosis; D054624:Health Status Disparities; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011379:Prognosis; D057216:Propensity Score; D012042:Registries; D012307:Risk Factors; D012422:Rupture, Spontaneous; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D012737:Sex Factors; D018084:Ultrasonography, Interventional; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000473:pathology
keywords: Age; Gender; ST elevation myocardial infarction; Virtual histology intravascular ultrasound