Sex-related differences in carotid plaque features and inflammation

被引:50
作者
Sangiorgi, Giuseppe [1 ]
Roversi, Sara [2 ]
Zoccai, Giuseppe Biondi [3 ]
Modena, Maria Grazia [2 ]
Servadei, Francesca [4 ]
Ippoliti, Arnaldo [5 ]
Mauriello, Alessandro [4 ]
机构
[1] Univ Roma Tor Vergata, Div Cardiol, Cardiac Catheterizat Lab, Rome, Italy
[2] Univ Modena & Reggio Emilia, Div Cardiol, I-41124 Modena, Italy
[3] Univ Roma La Sapienza, Dept Medicosurg Sci & Biotechnol, Latina, Italy
[4] Univ Roma Tor Vergata, Div Anat Pathol, Rome, Italy
[5] Univ Roma Tor Vergata, Div Vasc Surg, Rome, Italy
关键词
CORONARY-ARTERY INJURY; ATHEROSCLEROTIC PLAQUE; CARDIOVASCULAR-DISEASE; HEART-DISEASE; GENDER-DIFFERENCES; ISCHEMIC-STROKE; RISK-FACTORS; IN-VIVO; STENOSIS; WOMEN;
D O I
10.1016/j.jvs.2012.07.052
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: Severe carotid stenosis is a frequent cause of stroke in both men and women. Whereas several sex-related comparisons are available on coronary atherosclerosis, there are few data appraising gender-specific features of carotid plaques. We aimed to systematically compare the pathology and inflammatory features of carotid plaques in men vs women. Methods: Carotid plaque specimens were collected from patients undergoing surgical endarterectomy for asymptomatic or symptomatic carotid stenosis. Histologic analysis was performed, as well as measurements of plaque composition and inflammation. Results: A total of 457 patients were included (132 women, 325 men). Baseline analyses showed a greater prevalence of hypercholesterolemia, hypertension, and former smoking status in women, despite a higher Framingham Heart Score in men (all P < .05). Women had a lower prevalence of thrombotic plaques, smaller percentage area of necrotic core, and hemorrhage extension (all P < .05). Plaque inflammation analysis showed a lower concentration of inflammatory and, in particular, of macrophage foam cells in the plaque cap of women (both P < .05). These differences were, however, no longer significant at multivariable analysis, including several baseline features, such as symptom status and stenosis severity. Conclusions: Carotid plaques seem significantly different in women and men, but the main drivers of such pathologic differences are baseline features, including stenosis severity and symptom status. (J Vasc Surg 2013; 57: 338-44.)
引用
收藏
页码:338 / 344
页数:7
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