Sex differences in atheroma burden and endothelial function in patients with early coronary atherosclerosis.

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Serval ID
serval:BIB_D1D4E8B2C872
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Sex differences in atheroma burden and endothelial function in patients with early coronary atherosclerosis.
Journal
European Heart Journal
Author(s)
Han S.H., Bae J.H., Holmes D.R., Lennon R.J., Eeckhout E., Barsness G.W., Rihal C.S., Lerman A.
ISSN
1522-9645[electronic]
Publication state
Published
Issued date
2008
Volume
29
Number
11
Pages
1359-1369
Language
english
Abstract
AIMS: Women and men have different clinical presentations and outcomes in coronary artery disease (CAD). We tested the hypothesis that sex differences may influence coronary atherosclerotic burden and coronary endothelial function before development of obstructive CAD. METHODS AND RESULTS: A total of 142 patients (53 men, 89 women; mean +/- SD age, 49.3 +/- 11.7 years) with early CAD simultaneously underwent intravascular ultrasonography and coronary endothelial function assessment. Atheroma burden in the left main and proximal left anterior descending (LAD) arteries was significantly greater in men than women (median, 23.0% vs. 14.1%, P = 0.002; median, 40.1% vs. 29.3%, P = 0.001, respectively). Atheroma eccentricity in the proximal LAD artery was significantly higher in men than women (median, 0.89 vs. 0.80, P = 0.04). The length of the coronary segments with endothelial dysfunction was significantly longer in men than women (median, 39.2 vs. 11.1 mm, P = 0.002). In contrast, maximal coronary flow reserve was significantly lower in women than men (2.80 vs. 3.30, P < 0.001). Sex was an independent predictor of atheroma burden in the left main and proximal LAD arteries (both P < 0.05) by multivariate analysis. CONCLUSION: Men have greater atheroma burden, more eccentric atheroma, and more diffuse epicardial endothelial dysfunction than women. These results suggest that men have more severe structural and functional abnormalities in epicardial coronary arteries than women, even in patients with early atherosclerosis, which may result in the higher incidence rates of CAD and ST-segment myocardial infarction in men than women.
Keywords
Atherosclerosis/complications, Atherosclerosis/physiopathology, Coronary Artery Disease/complications, Coronary Artery Disease/physiopathology, Endosonography, Endothelium, Vascular/physiopathology, Female, Humans, Male, Middle Aged, Risk Factors, Sex Factors, Ultrasonography, Interventional
Pubmed
Web of science
Open Access
Yes
Create date
02/10/2009 17:55
Last modification date
01/10/2019 7:19
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