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
{"title":"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。","authors":"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","doi":"10.1016/j.atherosclerosis.2024.118568","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and aims</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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 <em>vs</em> 18.3 ± 8.5 mm, <em>p</em> = 0.048) and minimum lumen area (2.30 ± 1.42 <em>vs</em> 2.78 ± 1.54 mm<sup>2</sup>, <em>p</em> < 0.001) and minimum lumen diameter (1.39 ± 0.45 <em>vs</em> 1.54 ± 0.44 mm, <em>p</em> < 0.001) were smaller. The minimum fibrous cap thickness was smaller among females (96 ± 53 <em>vs</em> 112 ± 72 μm, <em>p</em> = 0.025), with more lesions harboring a thin cap fibroatheroma (39.3 % <em>vs</em> 24.9 %, <em>p</em> < 0.001). Major adverse cardiovascular events at two years occurred in 6.3 % of female patients and 11.8 % of male patients (<em>p</em> = 0.15).</p></div><div><h3>Conclusions</h3><p>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.</p></div>","PeriodicalId":8623,"journal":{"name":"Atherosclerosis","volume":"397 ","pages":"Article 118568"},"PeriodicalIF":4.9000,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0021915024011407/pdfft?md5=8fbe71f2004a86cb3f38808c6f6e1cbb&pid=1-s2.0-S0021915024011407-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Sex differences in plaque characteristics of fractional flow reserve-negative non-culprit lesions after myocardial infarction\",\"authors\":\"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\",\"doi\":\"10.1016/j.atherosclerosis.2024.118568\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and aims</h3><p>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.</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>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 <em>vs</em> 18.3 ± 8.5 mm, <em>p</em> = 0.048) and minimum lumen area (2.30 ± 1.42 <em>vs</em> 2.78 ± 1.54 mm<sup>2</sup>, <em>p</em> < 0.001) and minimum lumen diameter (1.39 ± 0.45 <em>vs</em> 1.54 ± 0.44 mm, <em>p</em> < 0.001) were smaller. The minimum fibrous cap thickness was smaller among females (96 ± 53 <em>vs</em> 112 ± 72 μm, <em>p</em> = 0.025), with more lesions harboring a thin cap fibroatheroma (39.3 % <em>vs</em> 24.9 %, <em>p</em> < 0.001). Major adverse cardiovascular events at two years occurred in 6.3 % of female patients and 11.8 % of male patients (<em>p</em> = 0.15).</p></div><div><h3>Conclusions</h3><p>FFR-negative NC lesions after MI harbored more high-risk plaque features in female patients. 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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.
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.