Purpose: Severe carotid stenosis is a frequent cause of stroke in both men and women. Whereas several sex-related comparisons are available on coronary plaque features, there are few data appraising gender-specific features of carotid plaques. We thus aimed to systematically compare the pathology of carotid plaques in males versus females. Methods: Carotid plaque specimens were collected from patients undergoing surgical thromboendoarterectomy for asymptomatic or symptomatic carotid stenosis. Standard pathologic analyses were performed, as well as sophisticated measurements for plaque hemorrhage, inflammation and foam cells. Results: A total of 457 patients were included (132 women, 325 men). Baseline analyses showed a greater prevalence of hypercholesterolemia and hypertension in women, and higher prevalence of current smoking, despite a raised Framingham Heart score in men (all p<0.05). Women had a lower prevalence of thrombotic plaques, and smaller percentage area of necrotic core and hemorrhage extension (all p<0.05). Plaque inflammation analysis showed a lower concentration of inflammatory and foam cells in the plaque cap of females (both p<0.05). Even at multivariable analysis adjusting for smoking status, hypercholesterolemia, hypertension, Framingham Heart Score, plaque classification, percentage area of necrotic lipid core, hemorrhage extension, women had a significantly lower concentration of foam cells and/or lymphocytes in the cap (p=0.032). Conclusions: Carotid plaques are significantly different in women and men. In contrast to findings observed in coronary vessels, females have a lower degree of inflammation and thrombosis, and more frequently stable plaques. Further studies are warranted to demonstrate whether such gender-related differences in carotid pathology may have implications for the clinical management and revascularization of patients with carotid artery disease.
Sangiorgi, G., Modena, M., Biondi Zoccai, G., Servadei, F., Liotti, D., Spagnoli, L., et al. (2011). Has gender a significant impact on carotid plaque instability and inflammation? Evidence from a 457-patient clinicopathologic study. EUROPEAN HEART JOURNAL, 32(S 1), 180 [10.1093/eurheartj/ehr322].
Has gender a significant impact on carotid plaque instability and inflammation? Evidence from a 457-patient clinicopathologic study
Sangiorgi, G;MAURIELLO, ALESSANDRO
2011-08-01
Abstract
Purpose: Severe carotid stenosis is a frequent cause of stroke in both men and women. Whereas several sex-related comparisons are available on coronary plaque features, there are few data appraising gender-specific features of carotid plaques. We thus aimed to systematically compare the pathology of carotid plaques in males versus females. Methods: Carotid plaque specimens were collected from patients undergoing surgical thromboendoarterectomy for asymptomatic or symptomatic carotid stenosis. Standard pathologic analyses were performed, as well as sophisticated measurements for plaque hemorrhage, inflammation and foam cells. Results: A total of 457 patients were included (132 women, 325 men). Baseline analyses showed a greater prevalence of hypercholesterolemia and hypertension in women, and higher prevalence of current smoking, despite a raised Framingham Heart score in men (all p<0.05). Women had a lower prevalence of thrombotic plaques, and smaller percentage area of necrotic core and hemorrhage extension (all p<0.05). Plaque inflammation analysis showed a lower concentration of inflammatory and foam cells in the plaque cap of females (both p<0.05). Even at multivariable analysis adjusting for smoking status, hypercholesterolemia, hypertension, Framingham Heart Score, plaque classification, percentage area of necrotic lipid core, hemorrhage extension, women had a significantly lower concentration of foam cells and/or lymphocytes in the cap (p=0.032). Conclusions: Carotid plaques are significantly different in women and men. In contrast to findings observed in coronary vessels, females have a lower degree of inflammation and thrombosis, and more frequently stable plaques. Further studies are warranted to demonstrate whether such gender-related differences in carotid pathology may have implications for the clinical management and revascularization of patients with carotid artery disease.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
