Sex differences in plaque characteristics of fractional flow reserve-negative non-culprit lesions after myocardial infarction.

Autor: Volleberg RHJA; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands., Mol JQ; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands., Belkacemi A; Department of Cardiology, AZ West Hospital, Veurne, Belgium., Hermanides RS; Department of Cardiology, Isala Hospital, Zwolle, the Netherlands., Meuwissen M; Department of Cardiology, Amphia Hospital, Breda, the Netherlands., Protopopov AV; Cardiovascular Center of Regional State Hospital, Krasnoyarsk, Russia; Krasnoyarsk State Medical University, Krasnoyarsk, Russia., Laanmets P; Cardiology Center, North Estonia Medical Center, Tallinn, Estonia., Krestyaninov OV; Meshalkin National Medical Research Center, Novosibirsk, Russia., Dennert R; Department of Cardiology, Dr. Horacio E. Oduber Hospital, Oranjestad, Aruba., Oemrawsingh RM; Department of Cardiology, Amphia Hospital, Breda, the Netherlands; Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands., van Kuijk JP; Department of Cardiology, Sint Antonius Hospital, Nieuwegein, the Netherlands., Arkenbout K; Department of Cardiology, Tergooi Hospital, Blaricum, the Netherlands., van der Heijden DJ; Department of Cardiology, Isala Hospital, Zwolle, the Netherlands; Department of Cardiology, Haaglanden Medical Center, The Hague, the Netherlands., Rasoul S; Department of Cardiology, Zuyderland Medical Center, Heerlen, the Netherlands; Department of Cardiology, MUMC+, Maastricht, the Netherlands., Lipsic E; Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands., Rodwell L; Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Medical Center, Nijmegen, the Netherlands., Camaro C; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands., Damman P; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands., Roleder T; Faculty of Medicine Wrocław University of Science and Technology, Department of Cardiology, Regional Specialist Hospital, Wrocław, Poland., Kedhi E; Department of Cardiology, McGill University Health Center, Royal Victoria Hospital, Montreal, Canada., van Leeuwen MAH; Department of Cardiology, Isala Hospital, Zwolle, the Netherlands., van Geuns RM; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands., van Royen N; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands. Electronic address: Niels.vanRoyen@radboudumc.nl.
Jazyk: angličtina
Zdroj: Atherosclerosis [Atherosclerosis] 2024 Oct; Vol. 397, pp. 118568. Date of Electronic Publication: 2024 Aug 22.
DOI: 10.1016/j.atherosclerosis.2024.118568
Abstrakt: Background and Aims: Recurrent events after myocardial infarction (MI) are common and often originate from native non-culprit (NC) lesions that are non-flow limiting. These lesions consequently pose as targets to improve long-term outcome. It is, however, largely unknown whether these lesions differ between sexes. The aim of this study was to assess such potential differences.
Methods: From the PECTUS-obs study, we assessed sex-related differences in plaque characteristics of fractional flow reserve (FFR)-negative intermediate NC lesions in 420 MI-patients.
Results: Among the included patients, 80 (19.1 %) were female and 340 (80.9 %) male. Women were older and more frequently had hypertension and diabetes. In total, 494 NC lesions were analyzed. After adjustment for clinical characteristics and accounting for within-patients clustering, lesion length was longer in female patients (20.8 ± 10.0 vs 18.3 ± 8.5 mm, p = 0.048) and minimum lumen area (2.30 ± 1.42 vs 2.78 ± 1.54 mm 2 , p < 0.001) and minimum lumen diameter (1.39 ± 0.45 vs 1.54 ± 0.44 mm, p < 0.001) were smaller. The minimum fibrous cap thickness was smaller among females (96 ± 53 vs 112 ± 72 μm, p = 0.025), with more lesions harboring a thin cap fibroatheroma (39.3 % vs 24.9 %, p < 0.001). Major adverse cardiovascular events at two years occurred in 6.3 % of female patients and 11.8 % of male patients (p = 0.15).
Conclusions: FFR-negative NC lesions after MI harbored more high-risk plaque features in female patients. Although this did not translate into an excess of recurrent events in female patients in this modestly sized cohort, it remains to be investigated whether this difference affects clinical outcome.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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