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Gender and the Extent of Coronary Atherosclerosis, Plaque Composition, and Clinical Outcomes in Acute Coronary Syndromes
Open accessAbstract
Objectives This study sought to assess the extent and composition of atherosclerosis contributing to acute coronary syndrome events in women compared with men. Background Pathological studies suggest that plaque composition and burden may differ by sex. It is unclear whether sex impacts the extent, characteristics, and potential vulnerability of coronary plaques. Methods A total of 697 patients (24% women) with acute coronary syndromes were enrolled in the prospective, multicenter PROSPECT (Providing Regional Observations to Study Predictors of Events in the Coronary Tree) study. Three-vessel multimodality intracoronary imaging (quantitative coronary angiography, grayscale, and radiofrequency intravascular ultrasound [IVUS]) was performed after treatment of the culprit lesion(s). Events during a median 3.4-year follow-up were ascribed to recurrent culprit versus untreated nonculprit lesions. The authors performed a post hoc, sex-based subgroup analysis. Results Women were older and had more comorbid disease than men. By angiography, women had a similar number of angiographic culprit (p = 0.53) but fewer nonculprit (p = 0.05) lesions, and fewer vessels with nonculprit lesions (p = 0.048) compared with men even after multivariable adjustment (p = 0.002). By IVUS, women had fewer nonculprit lesions (p = 0.002), but similar plaque burden (PB) per lesion (55.6% vs. 55.3%; p = 0.35), and female sex was not predictive of severe (> 70%) PB (p = 0.052). Plaque rupture was less common in women (6.6% vs. 16.3%; p = 0.002) even after adjusting for comorbidities (p = 0.004), as was the total necrotic core volume (p < 0.0001). The frequency of other plaque phenotypes was similar for men and women including pathological intimal thickening, thin-cap fibroatheromas (TCFA), and thick-cap fibroatheromas. Rates of major adverse cardiovascular events attributed to culprit and nonculprit lesions at 1-, 2-, and 3-year follow-up were not significantly different between men and women, although women were rehospitalized more frequently due to culprit lesion-related angina. For men, nonculprit lesion minimal lumen area ≤ 4.0 mm(2), PB ≥70%, and TCFA predicted nonculprit MACE at 3 years, whereas for women, only TCFA and PB were predictive. Conclusions The PROSPECT study validates that despite having more comorbid risk factors than men, women have less extensive coronary artery disease by both angiographic and IVUS measures, and that lesions in women compared with men have less plaque rupture, less necrotic core and calcium, similar plaque burden, and smaller lumens. TCFA may also be a stronger marker of plaque vulnerability in women than men.
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“Men were selected to optimize statistical power given the higher prevalence of CAD in men, particularly in the age group studied.35”
From Wearable-Derived Training Load and Coronary Atherosclerosis in Middle-Aged and Older Athletes and Physically Active Controls: A New Perspective From the Master@Heart Study (2026) · cites this paper as [35]
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Cites
A Prospective Natural-History Study of Coronary Atherosclerosis
Stone, G. W., Maehara, A., Lansky, A. J., Bruyne, B. D., Cristea, E., Mintz, G. S., Mehran, R., McPherson, J., Farhat, N. Z., Marso, S. P., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1002358 · Cited by 3,301
Self-citationPathophysiology of coronary artery disease
Libby, P., & Theroux, P. (2005) · Circulation · doi:10.1161/circulationaha.105.537878 · Cited by 1,965
Lerner, D., & Kannel, W. B. (1986) · American Heart Journal · doi:10.1016/0002-8703(86)90155-9 · Cited by 1,740
Coronary Plaque Erosion Without Rupture Into a Lipid Core
Farb, A. A., BURKE, A. P., Tang, A. L., Liang, Y.-H., Mannan, P., Smialek, J. E., & Virmani, R. (1996) · Circulation · doi:10.1161/01.cir.93.7.1354 · Cited by 1,272
Richardson, P. D. (1989) · The Lancet · doi:10.1016/s0140-6736(89)90953-7 · Cited by 1,258
Sex, Clinical Presentation, and Outcome in Patients with Acute Coronary Syndromes
Hochman, J. S., Tamis, J. E., Thompson, T., Weaver, W. D., White, H. D., de Werf, F. V., Aylward, P. E., Topol, E. J., & Califf, R. M. (1999) · New England Journal of Medicine · doi:10.1056/nejm199907223410402 · Cited by 901
Kolodgie, F. D., BURKE, A. P., Farb, A. A., Gold, H. K., Yuan, J., Narula, J., Finn, A. V., & Virmani, R. (2001) · Current Opinion in Cardiology · doi:10.1097/00001573-200109000-00006 · Cited by 694
Giroud, D., Li, J. M., Urban, P. M., Meier, B., & Rutishauser, W. (1992) · The American Journal of Cardiology · doi:10.1016/0002-9149(92)90495-k · Cited by 496
Angiographic evolution of coronary artery morphology in unstable angina
Ambrose, J. A., Winters, S. L., Arora, R. R., Eng, A., Riccio, A., Gorlin, R., & Fuster, V. (1986) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(86)80455-7 · Cited by 453
Frequency and Distribution of Thin-Cap Fibroatheroma and Ruptured Plaques in Human Coronary Arteries
Cheruvu, P. K., Finn, A. V., Gardner, C. M., Caplan, J. D., Goldstein, J. A., Stone, G. W., Virmani, R., & Muller, J. E. (2007) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2007.04.086 · Cited by 347
Self-citationPathology of the Thin‐Cap Fibroatheroma:
Virmani, R., BURKE, A. P., Kolodgie, F. D., & Farb, A. A. (2003) · Journal of Interventional Cardiology · doi:10.1034/j.1600-0854.2003.8042.x · Cited by 330
Nair, A., Mp, M., Kuban, B. D., & Vince, D. G. (2007) · PubMed · Cited by 320
Hackett, D., DAVIES, G., & Maseri, A. (1988) · European Heart Journal · doi:10.1093/oxfordjournals.eurheartj.a062449 · Cited by 289
Relationship of Thrombus Healing to Underlying Plaque Morphology in Sudden Coronary Death
Kramer, M. C. A., Rittersma, S. Z. H., de Winter, R. J., Ladich, E. R., Fowler, D. R., Liang, Y.-H., Kutys, R., Carter‐Monroe, N., Kolodgie, F. D., van der Wal, A. C., et al. (2009) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.09.007 · Cited by 270
Goldberg, R. J., O’Donnell, C., Yarzebski, J., Bigelow, C., Savageau, J. A., & Gore, J. M. (1998) · American Heart Journal · doi:10.1053/hj.1998.v136.88874 · Cited by 267
Akhter, N., Milford–Beland, S., Roe, M. T., Piana, R. N., Kao, J. A., & Shroff, A. R. (2008) · American Heart Journal · doi:10.1016/j.ahj.2008.08.012 · Cited by 259
Deaths: leading causes for 2004.
Heron, M. P. (2007) · PubMed · Cited by 233
Gender differences in acute myocardial infarction in the era of reperfusion (the MITRA registry)
Heer, T., Schiele, R., Schneider, S., Gitt, A. K., Wienbergen, H., Gottwik, M. G., Gieseler, U., Voigtländer, T., Hauptmann, K. E., Wagner, S., et al. (2002) · The American Journal of Cardiology · doi:10.1016/s0002-9149(01)02289-5 · Cited by 209
Murabito, J. M., Evans, J. C., Larson, M. G., & Levy, D. A. (1993) · Circulation · doi:10.1161/01.cir.88.6.2548 · Cited by 199
Effect of menopause on plaque morphologic characteristics in coronary atherosclerosis
BURKE, A. P., Farb, A. A., Malcom, G. T., & Virmani, R. (2001) · American Heart Journal · doi:10.1067/mhj.2001.109946 · Cited by 178
Diethrich, E. B., Margolis, M. P., Reid, D. B., BURKE, A. P., Ramaiah, V. G., Rodriguez‐Lopez, J. A., Wheatley, G. H., Olsen, D. M., & Virmani, R. (2007) · Journal of Endovascular Therapy · doi:10.1177/152660280701400512 · Cited by 156
Marso, S. P., Mercado, N. F., Maehara, A., Weisz, G., Mintz, G. S., McPherson, J., Schiele, F., Dudek, D., Fahy, M. P., Xu, K., et al. (2012) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2012.01.008 · Cited by 142
Self-citationLansky, A. J., da Costa, R. A., Mooney, M. R., Midei, M. G., Lui, H. K., Strickland, W., Mehran, R., Leon, M. B., Russell, M. E., Ellis, S. G., et al. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.10.076 · Cited by 128
Self-citationBaber, U., Stone, G. W., Weisz, G., Moreno, P., Dangas, G., Maehara, A., Mintz, G. S., Cristea, E., Fahy, M. P., Xu, K., et al. (2012) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2011.12.008 · Cited by 116
Self-citationMaehara, A., Cristea, E., Mintz, G. S., Lansky, A. J., Dressler, O., Biro, S., Templin, B., Virmani, R., Bruyne, B. D., Serruys, P. W. J. C., et al. (2012) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2011.11.019 · Cited by 82
Self-citationWykrzykowska, J. J., Mintz, G. S., García‐García, H. M., Maehara, A., Fahy, M. P., Xu, K., Inguez, A., Fajadet, J. C., Lansky, A. J., Templin, B., et al. (2012) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2012.01.006 · Cited by 80
Self-citationRate of Progression of Coronary Atherosclerotic Plaque in Women
Nicholls, S. J., Wolski, K., Sipahi, İ., Schoenhagen, P., Crowe, T. D., Kapadia, S. R., Hazen, S. L., Tuzcu, E. M., & Nissen, S. E. (2007) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.12.039 · Cited by 80
Mautner, S. L., Lin, F., Mautner, G. C., & Roberts, W. C. (1993) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(93)90302-h · Cited by 79
Kornowski, R., Lansky, A. J., Mintz, G. S., Kent, K. M., Pichard, A. D., Satler, L. F., Bucher, T. A., Popma, J. J., & Leon, M. B. (1997) · The American Journal of Cardiology · doi:10.1016/s0002-9149(97)00206-3 · Cited by 78
Self-citationIntravascular Ultrasound Study of Patterns of Calcium in Ruptured Coronary Plaques
Fujii, K., CARLIER, S. G., Mintz, G. S., Takebayashi, H., Yasuda, T., da Costa, R. A., Moussa, I. D., Dangas, G., Mehran, R., Lansky, A. J., et al. (2005) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2005.03.074 · Cited by 74
Self-citationHayashi, T., Kiyoshima, T., Matsuura, M., Ueno, M., Kobayashi, N., Yabushita, H., Kurooka, A., Taniguchi, M., Miyataka, M., Kimura, A., et al. (2005) · American Heart Journal · doi:10.1016/j.ahj.2004.06.020 · Cited by 54
Intravascular Ultrasound Profile Analysis of Ruptured Coronary Plaques
Fujii, K., Mintz, G. S., CARLIER, S. G., Costa, J. D. R., Kimura, M., Sano, K., Tanaka, K., da Costa, R. A., Lui, J., Stone, G. W., et al. (2006) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2006.03.020 · Cited by 50
Self-citationMcPherson, J., Maehara, A., Weisz, G., Mintz, G. S., Cristea, E., Mehran, R., Foster, M. C., Verheye, S., Rabbani, L. E., Xu, K., et al. (2012) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2012.01.005 · Cited by 48
Self-citationGender‐based evaluation of the XIENCE V™ everolimus‐eluting coronary stent system:
Lansky, A. J., Ng, V. G., Mutlu, H., Cristea, E., Guiran, J. B., Midei, M. G., Newman, W. N., Sanz, M. L., Sood, P., Doostzadeh, J., et al. (2009) · Catheterization and Cardiovascular Interventions · doi:10.1002/ccd.22067 · Cited by 41
Self-citationIs preinfarction angina related to the presence or absence of coronary plaque rupture?
Kojima, S., Nonogi, H., Miyao, Y., Miyazaki, S., Goto, Y., Itoh, A., Daikoku, S., Matsumoto, T., Morii, I., & Yutani, C. (2000) · Heart · doi:10.1136/heart.83.1.64 · Cited by 39
Sanidas, E. A., Mintz, G. S., Maehara, A., Cristea, E., Wennerblom, B., Íñiguez, A., Fajadet, J. C., Fahy, M. P., Dressler, O., Weisz, G., et al. (2012) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2011.08.024 · Cited by 26
Self-citationBrener, S. J., Mintz, G. S., Cristea, E., Weisz, G., Maehara, A., McPherson, J., Marso, S. P., Farhat, N. Z., Bøtker, H. E., Dressler, O., et al. (2012) · JACC. Cardiovascular imaging · doi:10.1016/j.jcmg.2011.12.007 · Cited by 25
Self-citationPresence of vulnerable coronary plaques in middle-aged individuals who suffered a brain death
Gurfinkel, E., Vigliano, C., Janavel, J. V., Fornoni, D., Caponi, G., Meckert, P. M. C., Bertolotti, A. M., Favaloro, R. R., & Laguens, R. M. (2009) · European Heart Journal · doi:10.1093/eurheartj/ehp303 · Cited by 13
Impact of Gender on Neointimal Hyperplasia Following Coronary Artery Stenting
Kaneda, H., Ako, J., Kataoka, T., Takahashi, T., Terashima, M., Waseda, K., Miyazawa, A., Hassan, A. H. M., Honda, Y., Yock, P. G., et al. (2006) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2006.09.094 · Cited by 8
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Acute Myocardial Infarction in Women: A Scientific Statement From the American Heart Association
Mehta, L. S., Beckie, T. M., DeVon, H. A., Grines, C. L., Krumholz, H. M., Johnson, M. N., Lindley, K. J., Vaccarino, V., Wang, T. Y., Watson, K. E., et al. (2016) · Circulation · doi:10.1161/cir.0000000000000351 · Cited by 1,244
Pathophysiology of Atherosclerosis
Jebari‐Benslaiman, S., Galicia-García, U., Larrea, A., Olaetxea, J. R., Alloza, I., Vandenbroeck, K., Benito‐Vicente, A., & Martı́n, C. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23063346 · Cited by 1,166
Farooq, V., Klaveren, D. V., Steyerberg, E. W., Meliga, E., Vergouwe, Y., Chieffo, A., Kappetein, A. P., Colombo, A., Holmes, D. R., Mack, M. J., et al. (2013) · The Lancet · doi:10.1016/s0140-6736(13)60108-7 · Cited by 853
Self-citationSteg, P. G., Greenlaw, N., Tardif, J., Tendera, M., Ford, I., Kääb, S., Abergel, H., Fox, K. M., Ferrari, R., & on behalf of the CLARIFY Registry Investigators (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs289 · Cited by 653
Ferencik, M., Mayrhofer, T., Bittner, D. O., Emami, H., Puchner, S. B., Lu, M. T., Meyersohn, N. M., Ivanov, A. V., Adami, E. C., Patel, M. R., et al. (2018) · JAMA Cardiology · doi:10.1001/jamacardio.2017.4973 · Cited by 562
Metadata
- Authors
- Lansky, A. J., Ng, V. G., Maehara, A., Weisz, G., Lerman, A., Mintz, G. S., De Bruyne, B., Farhat, N., Niess, G., Jankovic, I., Lazar, D., Xu, K., Fahy, M., Serruys, P. W., & Stone, G. W.
- Affiliations
- Yale University (US)
- Columbia University Irving Medical Center (US)
- Mayo Clinic (US)
- Presbyterian Hospital (US)
- Erasmus MC (NL)
- Corresponding author
- Lansky, Alexandra J.
- ORCID
- Venue
- JACC: Cardiovascular Imaging
- Publisher
- Elsevier BV
- Published
- 2012-03
- Volume
- 5
- Issue
- 3
- Pages
- S62-S72
- ISSN
- 1876-7591 (ISSN-L)
- 1936-878X
- OpenAlex
- W2079106078
- Cited by
- 289
- References
- 39
- Citations by year
- 2026: 6 · 2025: 15 · 2024: 24 · 2023: 17 · 2022: 16 · 2021: 25 · 2020: 31 · 2019: 18 · 2018: 24 · 2017: 13 · 2016: 38 · 2015: 19 · 2014: 9 · 2013: 17 · 2012: 17
- FWCI
- 20.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- JACC. Cardiovascular imaging (publishedVersion)
- PubMed (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Funders
- Boston Scientific Corporation
- InfraRedx
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- acute coronary syndrome, sex differences, coronary artery disease, plaque composition, plaque burden, plaque rupture, necrotic core, thin-cap fibroatheroma, non-culprit lesions, major adverse cardiovascular events, women, intravascular ultrasound, quantitative coronary angiography, culprit lesion, hospital readmission, angina pectoris, PROSPECT study
- MeSH terms
- Aged, Angina, Unstable, Coronary Artery Disease, Europe, Female, Fibrosis, Heart Arrest, Humans, Male, Middle Aged, Myocardial Infarction, Necrosis, Predictive Value of Tests, Prospective Studies, Risk Factors, Severity of Illness Index, Sex Factors, Time Factors, United States, Angioplasty, Balloon, Coronary, Multivariate Analysis, Chi-Square Distribution, Logistic Models, Proportional Hazards Models, Treatment Outcome, Coronary Angiography, Ultrasonography, Interventional, Risk Assessment, Coronary Stenosis, Kaplan-Meier Estimate, Acute Coronary Syndrome, Plaque, Atherosclerotic, Vascular Calcification
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