In-vivo comparison of coronary plaque characteristics using optical coherence tomography in women vs. men with acute coronary syndrome

ObjectiveWomen with acute coronary syndromes (ACS) have worse outcomes than men. Data on sex differences of culprit plaque characteristics are lacking. Intravascular optical coherence tomography (OCT) is a high-resolution imaging technique capable of in-vivo plaque characterization. The aim of this study was to compare culprit plaque characteristics in women and men presenting with ACS. MethodsPatients undergoing coronary angiography after ACS were enrolled. We performed OCT imaging on the culprit lesions. Previously validated criteria for OCT plaque characterization were used: lipid was quantified on cross-sectional image and lipid-rich plaque was defined as ≥2 involved quadrants; fibrous cap thickness was measured at the thinnest point and thin-cap fibroatheroma was defined as lipid-rich plaque with fibrous cap thickness less than 65 μm. ResultsForty-two patients (33 men and nine women) were included. No significant sex differences were found in baseline characteristics. Lipid-rich plaques were identified in majority of patients. No significant difference, however, was seen in the frequency of lipid-rich plaques, thin-cap fibroatheroma or minimum fibrous cap thickness (79 vs. 89%; 45 vs. 67%; 53.8 vs. 45.4 μm, respectively; P=NS) between men and women. Incidence of calcification, thrombus and plaque disruption were also similar. ConclusionsNo significant sex difference was seen in culprit plaque characteristics determined by OCT imaging in patients who presented with ACS.