Sex-related differences in carotid plaque features and inflammation

作者：Sangiorgi Giuseppe; Roversi Sara^*; Zoccai Giuseppe Biondi; Modena Maria Grazia; Servadei Francesca; Ippoliti Arnaldo; Mauriello Alessandro

来源：Journal of Vascular Surgery, 2013, 57(2): 338-344.

DOI：10.1016/j.jvs.2012.07.052

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. %26lt;br%26gt;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. %26lt;br%26gt;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 %26lt; .05). Women had a lower prevalence of thrombotic plaques, smaller percentage area of necrotic core, and hemorrhage extension (all P %26lt; .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 %26lt; .05). These differences were, however, no longer significant at multivariable analysis, including several baseline features, such as symptom status and stenosis severity. %26lt;br%26gt;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.)

• 出版日期2013-2