Female sex impact on culprit plaque at optical coherence tomography analysis in the setting of acute coronary syndrome in OCT-FORMIDABLE registry

摘要

Aim: To evaluate sex difference in culprit plaque features at optical coherence tomography (OCT) and major adverse cardiovascular events at follow-up. Patients and methods: We analyse data from the OCT-FORMIDABLE (OCT-Features Of moRphology, coMposItion anD instABility of culprit and pLaquE in acute coronary syndrome [ACS] patients) registry. A total of 285 patients (20%, 58 females) were included. Results:?Females with ST segment elevation myocardial infarction showed a longer ruptured area of the plaque (8.6?±?7.6 vs 4.6?±?5.4;?p?=?0.003) and a major necrotic core macrophage infiltration (43 vs 17%;?p?=?0.017). Females with non-ST segment elevation-ACS had less lipidic plaques (62 vs 80%;?p?=?0.04). No between-group sex differences in major adverse cardiovascular events emerged at follow-up (5 vs 9%;?p?=?0.88 in ST segment elevation myocardial infarction group and 19 vs 15%;?p?=?0.6 in non-ST segment elevation-ACS group). At multivariate analysis, female sex was not a major risk of plaque rupture (hazard ratio [HR]: 1.59, CI: 0.44–5.67;?p?=?0.48). Conclusion: Female sex seems to have no significant impact.ClincalTrial. gov registration number: NCT02486861.