Mensink Frans B, Ten Cate Tim J F, Damen Sander A J, Roes Kit, Di Mario Carlo, Singh Varinder, Ali Ziad A, Skinner William, Artis Andre, Torguson Rebecca, Zhang Cheng, Doros Gheorghe, Garcia-Garcia Hector M, Mintz Gary S, Geuns Robert-Jan van, Waksman Ron
Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
Structural Interventional Cardiology, Department of Clinical & Experimental Medicine, Careggi University Hospital, Florence, Italy.
Int J Cardiol Heart Vasc. 2022 Mar 8;39:100985. doi: 10.1016/j.ijcha.2022.100985. eCollection 2022 Apr.
The Lipid Rich Plaque (LRP) study demonstrated that near-infrared spectroscopy imaging of non-obstructive lesions identified patients and segments at higher risk for subsequent non-culprit major adverse cardiac events (NC-MACE). Whether this is true for both men and women is not known. In this analysis of the LRP study, we sought to investigate whether the maximum 4-mm Lipid Core Burden Index (maxLCBI) was of similar predictive value in men and women for NC-MACE.
Patients with an evaluable maxLCBI were stratified on the basis of sex at birth. A Cox proportional-hazards model was used to assess the predictive value of maxLCBI on future NC-MACE at the patient and plaque levels. The primary endpoint was cumulative incidence of NC-MACE at 24 months.
Among 1271 patients, 388 (30.5%) were women. Women were older and had a higher cardiovascular risk profile. Cumulative incidence of NC-MACE at 24 months was 10.3% for women and 7.6% for men (log-rank p = 0.11). When comparing maxLCBI > 400 to maxLCBI ≤ 400, the hazard ratio (HR) for future NC-MACE was not significantly different between sexes: 2.10 (95% confidence interval [CI]: 1.28-3.44; p = 0.003) for men and 2.24 (95% CI: 1.18-4.28; p = 0.014) for women (p = 0.87). At the plaque level, the HR comparing maxLCBI > 400 to maxLCBI ≤ 400 was 3.49 (95% CI: 1.60-7.60, p = 0.002) for men and 4.79 (95% CI: 2.02-11.38, p < 0.001) for women, which was not significantly different (p = 0.57).
The maxLCBI was of similar predictive value for NC-MACE within 24 months in men and women.
富含脂质斑块（LRP）研究表明，对非阻塞性病变进行近红外光谱成像可识别出后续发生非罪犯相关主要不良心脏事件（NC-MACE）风险较高的患者和节段。但这在男性和女性中是否均成立尚不清楚。在对LRP研究的此项分析中，我们旨在探究最大4毫米脂质核心负荷指数（maxLCBI）在男性和女性中对NC-MACE是否具有相似的预测价值。
根据出生时的性别对具有可评估maxLCBI的患者进行分层。采用Cox比例风险模型评估maxLCBI在患者和斑块水平对未来NC-MACE的预测价值。主要终点为24个月时NC-MACE的累积发生率。
在1271例患者中，388例（30.5%）为女性。女性年龄更大，心血管风险特征更高。女性24个月时NC-MACE的累积发生率为10.3%，男性为7.6%（对数秩检验p = 0.11）。当比较maxLCBI > 400与maxLCBI≤400时，未来NC-MACE的风险比（HR）在性别之间无显著差异：男性为2.10（95%置信区间[CI]：1.28 - 3.44；p = 0.003），女性为2.24（95% CI：1.18 - 4.28；p = 0.014）（p = 0.87）。在斑块水平，比较maxLCBI > 40,0与maxLCBI≤400时，男性的HR为3.49（95% CI：1.60 - 7.60，p = 0.002），女性为4.79（95% CI：2.02 - 11.38，p < 0.001），两者无显著差异（p = 0.57）。
maxLCBI在男性和女性中对24个月内的NC-MACE具有相似的预测价值。
