心肌梗死后分数血流储备阴性非病灶斑块特征的性别差异。

IF 4.9 2区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Atherosclerosis Pub Date : 2024-08-22 DOI:10.1016/j.atherosclerosis.2024.118568
Rick H.J.A. Volleberg , Jan-Quinten Mol , Anouar Belkacemi , Renicus S. Hermanides , Martijn Meuwissen , Alexey V. Protopopov , Peep Laanmets , Oleg V. Krestyaninov , Robert Dennert , Rohit M. Oemrawsingh , Jan-Peter van Kuijk , Karin Arkenbout , Dirk J. van der Heijden , Saman Rasoul , Erik Lipsic , Laura Rodwell , Cyril Camaro , Peter Damman , Tomasz Roleder , Elvin Kedhi , Niels van Royen
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引用次数: 0

摘要

背景和目的:心肌梗死(MI)后复发的情况很常见,而且往往源于非血流受限的原发性非梗死(NC)病变。因此,这些病变是改善长期预后的目标。然而,这些病变在性别上是否存在差异在很大程度上还是个未知数。本研究旨在评估这种潜在的差异:方法:在 PECTUS-obs 研究中,我们评估了 420 名心肌梗死患者中分数血流储备(FFR)阴性的中间 NC 病变斑块特征中与性别相关的差异:在纳入的患者中,80 名(19.1%)为女性,340 名(80.9%)为男性。女性年龄更大,患有高血压和糖尿病的更多。共分析了 494 例 NC 病变。在对临床特征进行调整并考虑患者内部聚类因素后,女性患者的病变长度(20.8 ± 10.0 vs 18.3 ± 8.5 mm,p = 0.048)和最小管腔面积(2.30 ± 1.42 vs 2.78 ± 1.54 mm2,p 结论:女性患者的病变长度和最小管腔面积均大于男性:女性患者心肌梗死后 FFR 阴性的 NC 病变具有更多的高风险斑块特征。虽然在这个规模不大的队列中,女性患者的复发率并没有因此而增加,但这种差异是否会影响临床结果仍有待研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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

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 mm2, 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.

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来源期刊
Atherosclerosis
Atherosclerosis 医学-外周血管病
CiteScore
9.80
自引率
3.80%
发文量
1269
审稿时长
36 days
期刊介绍: Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.
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