Assessment With Multi-Slice Computed Tomography and Gray-Scale and Virtual Histology Intravascular Ultrasound of Gender-Specific Differences in Extent and Composition of Coronary Atherosclerotic Plaques in Relation to Age

• Published in: The American journal of cardiology Vol. 105; no. 4; pp. 480 - 486
• Main Authors: Pundziute, Gabija, MD, PhD, Schuijf, Joanne D., PhD, van Velzen, Joella E., MD, Jukema, J. Wouter, MD, PhD, van Werkhoven, Jacob M., MSc, Nucifora, Gaetano, MD, van der Kley, Frank, MD, Kroft, Lucia J., MD, PhD, de Roos, Albert, MD, PhD, Boersma, Eric, PhD, Reiber, Johan H.C., PhD, Schalij, Martin J., MD, PhD, van der Wall, Ernst E., MD, PhD, Bax, Jeroen J., MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15.02.2010; Elsevier; Elsevier Limited
• Subjects: Age differences; Age Distribution; Age Factors; Aged; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Calcinosis - diagnostic imaging; Calcinosis - pathology; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Coronary Angiography - methods; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - pathology; Coronary heart disease; Female; Gender differences; Heart; Histology; Humans; Male; Medical sciences; Middle Aged; Predictive Value of Tests; Reproducibility of Results; Retrospective Studies; Risk Factors; Sensitivity and Specificity; Severity of Illness Index; Sex Distribution; Sex Factors; Tomography; Tomography, X-Ray Computed; Ultrasonic imaging; Ultrasonography, Interventional; User-Computer Interface; Sonography; Composition; Radiodiagnosis; Evaluation scale; Coronary artery; Sex; Cardiovascular disease; Histology; Coronary heart disease; Vascular disease; Atherosclerotic plaque; Atherosclerosis; Medical imagery; Multislice; Computerized axial tomography; Circulatory system; Cardiology; Ultrasound; Age; Comparative study
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2009.09.054

Data evaluating gender- and age-specific differences in plaque observations on multislice computed tomography (MSCT) are scarce. Accordingly, the aim of this study was to evaluate coronary plaque patterns in men and women in relation to age using MSCT. The findings were compared to observations on grayscale intravascular ultrasound (IVUS) and virtual histology (VH) IVUS. In total, 93 patients (59 men, 34 women) underwent 64-slice MSCT followed by conventional coronary angiography with IVUS. Plaque extent and composition were assessed on MSCT, grayscale IVUS, and VH IVUS. Coronary plaque patterns were compared between men and women in 2 age groups (<65 and ≥65 years old). In patients aged <65 years, more plaques were observed on MSCT in men (6 ± 4 vs 2 ± 2 in women, p <0.001). Also, a larger plaque burden was observed on grayscale IVUS in men (45.7 ± 11.4% vs 36.3 ± 11.6% in women, p <0.001). Similarly, more mixed plaques were observed in men (3 ± 3 vs 1 ± 1 in women, p = 0.003), whereas a larger arc of calcium was detected on grayscale IVUS in men (91.7 ± 93.5° vs 25.7 ± 51.0° in women, p <0.001). On VH IVUS, the prevalence of thin-cap fibroatheroma was higher in men (31% vs 0%) compared to women. In patients aged ≥65 years old, no important differences in plaque patterns were observed between men and women. In conclusion, more extensive atherosclerosis and more calcified lesions were observed in men than in women. These differences were predominantly present in patients aged <65 years and were lost in those aged ≥65 years.