Gender Differences In Plaque Characteristics In Patients With Coronary Heart Disease

Background In recent years,the mortality rate of coronary heart disease in men has been on a downward trend worldwide,but the mortality rate of female patients continues to increase.Significant correlation between plaque characteristics and prognosis in patients with coronary heart disease.Few studies on plaque characteristics in postmenopausal women and men with coronary heart disease.Objective To investigate the differences of coronary atherosclerotic plaque characteristics in postmenopausal women and men with coronary heart disease.The aim of the study is to provide a theoretical basis for the rational formulation of interventions for postmenopausal women with coronary heart disease,and ultimately to reduce the mortality of postmenopausal women with coronary heart disease.Methods A retrospective analysis method was used in this study.A total of 116 patients who hospitalized in the Shaanxi People's Hospital cardiovascular hospital from May 1,2016 to December 31,2017 with coronary atherosclerotic heart disease simultaneously underwent coronary angiography and intravascular ultrasonography assessment.All patients were divided into two groups of men and women according to sex.The risk factors,the characteristics of coronary angiography and the characteristics of intravascular ultrasound were statistically analyzed.Results(1)In this study,a total of 146 samples were collected,30 samples were excluded,and finally 116 samples were enrolled,including 30 men and 86 women.(2)Among 116 patients with coronary heart disease,women had a higher age of onset than men(65.20±8.86 vs 61.21±9.39,P<0.05).Women's past smoking,smoking time and total smoking were less than men [(0.0% vs 59.3%,P<0.01),(0.07±0.36 vs 18.65±17.93,P<0.01),(0.00±0.00 vs 13.41±16.39,P<0.01)].Women have higher prevalence of hypertension and blood pressure ratings than men [(70.0% vs 44.2%,P<0.05),(normal,grade 1,grade 2,grade3;26.7% vs 57.0%,3.3% vs 3.5%,16.7% vs 12.8%,53.3% vs 26.7%,P<0.05)].Female Creatinine and Uric acid are lower than men [(69.66±16.81 vs 83.68±25.64,P<0.01),(278.87±82.58 vs 337.01±79.00,P<0.01)].(3)The proportion of left main lesions women is lower than men(10.0% vs 33.7%,P<0.05).(4)Female distal reference external elastic membrane cross-sectional area,proximal reference external elastic membrane cross-sectional area and lesional vascular external elastic membrane cross-sectional area are smaller than men[(12.22±4.74 vs 15.84±7.69,P<0.01),(15.95±8.05 vs 19.62±7.19,P<0.05),(12.89±6.78 vs 16.12±6.49,P<0.05)].Female Maximum plaque plus media thickness and plaque eccentricity index are less than men [(1.14±0.35 vs 2.00±0.60,P<0.01),(0.69±0.24 vs 0.79±0.19,P<0.05)].Female Plaque plus media cross-sectional area is less than male(9.22±5.33 vs 12.00±5.64,P<0.05).Conclusions(1)Postmenopausal women and men have some common risk factors for coronary heart disease,but women have their own specificity.(2)There are gender differences in the features of coronary angiography in postmenopausal women and men with coronary heart disease.The proportion of left main lesions women is lower than men.(3)Coronary plaque characteristics in postmenopausal women and men with coronary heart disease have some common features,but postmenopausal women have their own characteristics.Postmenopausal women have less plaque eccentricity index than men,suggesting that postmenopausal women have a lower risk of acute cardiovascular events due to plaque rupture than men.