Comparison of men versus women in cross-sectional area luminal narrowing, quantity of plaque, presence of calcium in plaque, and lumen location in coronary arteries by intravascular ultrasound in patients with stable angina pectoris

Women have an increased mortality after coronary interventions compared with men, which may be partly explained by differences in comorbid clinical conditions. However, whether women also have quantitative differences in coronary atherosclerosis is not known. Preinterventional intravascular ultrasound (IVUS) was used to study de nova, nonostial native coronary lesions in 169 women and 549 men with chronic angina. The external elastic membrane (EEM), lumen, and plaque + media (P + M) areas, plaque burden, plaque eccentricity, and calcium were measured at the target lesion and at a proximal reference site. All cross-sectional IVUS measures were also corrected for body surface area. Results are reported as mean ± 1 SD. Women had significantly smaller reference site EEM (16.5 ± 5.3 vs 19.4 ± 6.3 mm², p <0,0001), lumen (8.7 ± 3.0 vs 9.9 ± 4.0 mm², p = 0.0020), and P + M areas (7.8 ± 3.7 vs 9.5 ± 4.2 mm², p = 0.0001). Women also had significantly smaller lesion site EEM (16.2 ± 5.9 vs 18.3 ± 6.7 mm², p = 0.0028), lumen (2.4 ± 1.7 vs 2.9 ± 2.6 mm², p = 0.0273), and P + M areas (13.6 ± 5.7 vs 15.3 ± 6.4 mm², p = 0.0112). However, when corrected for BSA, these differences were no longer significant. Women and men also had similar reference and lesion plaque burden, eccentricity, and calcium. Preinterventional IVUS analysis failed to detect any quantitative or qualitative differences in coronary atherosclerosis in men compared with women.