Abstract 12786: Characteristics of Plaque Microstructures in Women: Insights from Frequency Domain Optical Coherence Tomography Analysis
Background: Clinical studies indicate that gender has important influences on the pathophysiology of atherosclerosis with different pattern of clinical presentation in women. Plaque microstructures have been considered to associate with plaque vulnerability, leading to acute ischemic events. However, it remains to be determined whether plaque vulnerability features differ in women.
Methods: We analyzed 210 non-culprit lipid plaques in 111 stable patients (male/female: 78/33, 62.8±9.7/61.3±10.6 years) who underwent frequency domain optical coherence tomography (FD-OCT) imaging within target vessel for percutaneous coronary intervention. FD-OCT derived plaque microstructures were compared between genders.
Results: The number of non-culprit lipid plaque per patient was similar in men and women (1.89 v. 1.90, p=0.67). Women were more likely to be obese (BMI: 31.8 v. 29.7, p=0.01) and have a history of hypertension (75 v. 50%, p≤0.01) and metabolic syndrome (57 v. 38%, p=0.01). Under the less frequent use of anti-atherosclerotic therapies in women (aspirin: 77 v. 92%, p≤0.01, ACE-I: 33 v. 54%, p≤0.01, statin: 46 v. 66%, p≤0.01), higher LDL-C (116 v. 87 mg/dl, p≤0.01), total cholesterol (197 v. 156 mg/dl, p≤0.01) and triglyceride (median: 158 v. 126 mg/dl, p=0.01) levels were observed. FD-OCT demonstrated that plaques in women had lower prevalence of cholesterol crystal, smaller arc and shorter length of calcification (Table). By contrast, fibrous cap thickness, the prevalence of microchannel and lipid arc did not differ between genders. When adjusted for differences in clinical characteristics, distinct features of calcification (p=0.01) and cholesterol crystallization (p=0.03) still existed.
Conclusions: Gender associated differences in FD-OCT derived features of vulnerable plaques were observed. The relationship with clinical outcomes in women requires further investigation.
- © 2013 by American Heart Association, Inc.