title: Sex differences in plaque characteristics by intravascular imaging in patients with coronary artery disease.
abstract: OBJECTIVE
  We aimed to study sex differences in coronary plaque burden and plaque composition in patients with coronary artery disease (CAD).
  
  
  RESULTS
  Virtual histology intravascular ultrasound (VH-IVUS) and near-infrared spectroscopy (NIRS) imaging of a non-culprit coronary artery was performed in 178 (23.5%) women and 581 (76.5%) men who underwent invasive management of stable angina pectoris (SAP) or acute coronary syndrome (ACS). Women were older and had a worse cardiovascular risk profile than men, but less extended angiographic coronary disease. Irrespective of the presenting diagnosis, women had lower VH-IVUS-derived plaque burden than men (38.1% vs. 40.5% in SAP, and 35.9% vs. 38.8% in ACS). Standardised (mean 211 vs. 263 mm3 in SAP, and 199 vs. 245 mm3 in ACS) total plaque volume was lower in women. Volumes of fibrous tissue, fibro-fatty tissue, necrotic core and dense calcium were also lower in women. NIRS-derived lipid core burden index (LCBI) was lower in women, in particular in SAP (mean LCBI in the worst 4 mm 220 vs. 240). The observed differences remained significant after adjustment for clinical characteristics.
  
  
  CONCLUSIONS
  Women had more favourable plaque characteristics than men, despite their worse risk profile. Long-term follow-up studies are required to evaluate the clinical consequences.
authors.affiliation: Department of Cardiology, VU University Medical Center Amsterdam, Amsterdam, the Netherlands.
authors.forename: Monique E
authors.initials: ME
authors.lastname: Ten Haaf
authors.forename: Melissa
authors.initials: M
authors.lastname: Rijndertse
authors.forename: Jin M
authors.initials: JM
authors.lastname: Cheng
authors.forename: Sanneke P
authors.initials: SP
authors.lastname: de Boer
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
authors.forename: Robert-Jan M
authors.initials: RM
authors.lastname: van Geuns
authors.forename: Evelyn
authors.initials: E
authors.lastname: Regar
authors.forename: Mattie J
authors.initials: MJ
authors.lastname: Lenzen
authors.forename: Yolande
authors.initials: Y
authors.lastname: Appelman
authors.forename: Eric
authors.initials: E
authors.lastname: Boersma
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging; D000368:Aged; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000000981:diagnostic imaging*; D012307:Risk Factors; D012727:Sex Characteristics; D019265:Spectroscopy, Near-Infrared / Q000379:methods; D018084:Ultrasonography, Interventional / Q000379:methods