Abstract：
Outcomes after myocardial infarction in women remain poor. The number of cardiovascular risk factors in women increase with age, however the relation between risk factors and culprit plaque characteristics in this population is poorly understood. The aim of the study was to investigate the relation between risk factors and culprit plaque characteristics in women with acute coronary syndrome (ACS). A total of 382 women who presented with ACS and underwent pre-intervention optical coherence tomography imaging of the culprit lesion were included in this analysis. The culprit plaques were categorized as plaque rupture, plaque erosion or calcified plaque, and then stratified by age and risk factors. The predominant pathology of ACS was plaque erosion in young patients (<60 years), which decreased with age (p <0.001). Current smokers had a high prevalence of plaque rupture (60%) and lipid plaque (79%). Women with diabetes tended to have more lipid plaque (70%) even at a young age. In women with hyperlipidemia, the prevalence of lipid plaques was modest in younger ages, but rose gradually with age (p <0.001). An increasing age trend for lipid plaque was also observed in women with hypertension (p = 0.03) and current smokers (p = 0.01). In conclusion, early treatment of risk factors such as diabetes in young women might be important before accelerated progression of atherosclerosis begins as age advances. Clinical trial registration: http://www.clinicaltrials.gov, NCT01110538, NCT03479723 and NCT02041650.
摘要：
女性心肌梗塞后的结果仍然很差。女性心血管危险因素的数量随着年龄的增长而增加，然而，在这一人群中，危险因素与罪犯斑块特征之间的关系知之甚少。该研究的目的是探讨急性冠状动脉综合征（ACS）女性的危险因素与罪犯斑块特征之间的关系。共有382名患有ACS并接受了罪犯病变的介入前光学相干断层扫描成像的女性被纳入本分析。罪魁祸首斑块被归类为斑块破裂，斑块侵蚀或钙化斑块，然后按年龄和危险因素分层。ACS的主要病理是年轻患者（<60岁）的斑块糜烂，随着年龄的增长而下降（p<0.001）。目前吸烟者的斑块破裂（60％）和脂质斑块（79％）的患病率很高。患有糖尿病的女性即使在年轻时也倾向于有更多的脂质斑块(70%)。在患有高脂血症的女性中，在较年轻的年龄中，脂质斑块的患病率适中，但随着年龄的增长逐渐上升(p<0.001)。在患有高血压（p=0.03）和当前吸烟者（p=0.01）的女性中也观察到脂质斑块的年龄增加趋势。总之,在随着年龄的增长动脉粥样硬化开始加速进展之前，对年轻女性的糖尿病等危险因素的早期治疗可能很重要。临床试验注册：http：//www。clinicaltrials.gov,NCT01110538、NCT03479723和NCT02041650。
