[疑似冠状动脉疾病的女性与男性相比，冠状动脉斑块的患病率、严重程度、特征及冠状动脉钙化评分存在差异]

[Prevalence, severity, characteristics and coronary calcified score of coronary artery plaques are different in women than men with suspected coronary artery disease].

作者信息

Sun Yujiao, Qi Guoxian, Yu Xin, Zhi Ying, Geng Song, Li Hua, Liu Ting, Xu Ke, Tian Wen

机构信息

Department of Cardiology, Department of Cardiology of Aging, the First Affiliated Hospital of China Medical University, Shenyang 110001, China.

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出版信息

Zhonghua Yi Xue Za Zhi. 2015 Nov 3;95(41):3337-42.

PMID:26812972

Abstract

OBJECTIVE

To validate the prevalence, severity, characteristics and coronary calcified score(CACS) of coronary artery plaques in women are different from men.

METHODS

A total of 3 752 patients with suspected coronary artery disease in the First Affiliated Hospital of China Medical University were enrolled between September 2011 and December 2013. Patients with suspect CAD underwent 256-detecter coronary computed tomography (CCTA) and CACS measurement were enrolled. The differences of sex-associated coronary artery plaques were assessed. The univariable and multivariable Logistic regression were employ to assess the association female and male with coronary artery plaques.

RESULTS

A total of 3 752 patients including 1 832 females and 1 920 males, the average age of the patients was (56 ± 11) years. Women were older and less smoker than men. The prevalences of any plaque, 2-,3-/LM disease and significant/severe stenosis significantly decreased in female than male (all P<0.01). The proportion of non-calcified plaques significantly higher and mixed plaque significantly lower in female than male (all P<0.01). the proportion of women were significantly lower than men in CACS>0 (all P<0.01). The similar tendency also happened in four age-matched female and male subgroups. After adjustment, female was the significant protective factor for significant and severe stenosis, 2- and 3-/LM vessel disease, calcified and mixed plaques, and CACS>100 (all P<0.01); female was the significant protective factor for non-calcified plaques in the univariate analysis (P<0.01). When the age ≥ 65, female became the significant risk factor for coronary artery plaques (all P<0.01).

CONCLUSIONS

Women have less prevalence and extensive coronary artery plaques and lower CACS, the plaque characteristics in women is more frequently composed by non-calcified plaques than men, even after matched by age. With age, female change from a protective factor to a risk factor for coronary artery plaques.

摘要

目的

验证女性冠状动脉斑块的患病率、严重程度、特征及冠状动脉钙化积分（CACS）与男性不同。

方法

2011年9月至2013年12月，中国医科大学附属第一医院共纳入3752例疑似冠心病患者。纳入接受256层冠状动脉计算机断层扫描（CCTA）及CACS测量的疑似冠心病患者。评估性别相关冠状动脉斑块的差异。采用单因素和多因素Logistic回归评估女性和男性与冠状动脉斑块的关联。

结果

共3752例患者，其中女性1832例，男性1920例，患者平均年龄为（56±11）岁。女性比男性年龄大且吸烟较少。女性任何斑块、2支、3支/左主干病变及显著/重度狭窄的患病率均显著低于男性（均P<0.01）。女性非钙化斑块比例显著高于男性，混合斑块比例显著低于男性（均P<0.01）。女性CACS>0的比例显著低于男性（均P<0.01）。在四个年龄匹配的女性和男性亚组中也出现了类似趋势。调整后，女性是显著和重度狭窄、2支和3支/左主干血管病变、钙化和混合斑块以及CACS>100的显著保护因素（均P<0.01）；在单因素分析中，女性是非钙化斑块的显著保护因素（P<0.01）。当年龄≥65岁时，女性成为冠状动脉斑块的显著危险因素（均P<0.01）。