The effect of sex differences on neointimal characteristics of in-stent restenosis in drug-eluting stents: An optical coherence tomography study

Xiaohang Yuan; Mengting Jiang; Huanhuan Feng; Yan Han; Xi Zhang; Yundai Chen; Lei Gao

doi:10.1016/j.heliyon.2023.e19073

The effect of sex differences on neointimal characteristics of in-stent restenosis in drug-eluting stents: An optical coherence tomography study

Heliyon. 2023 Aug 11;9(8):e19073. doi: 10.1016/j.heliyon.2023.e19073. eCollection 2023 Aug.

Authors

Xiaohang Yuan^{1

2}, Mengting Jiang^{1

2}, Huanhuan Feng^{1

3}, Yan Han^{1

2}, Xi Zhang^{1

2}, Yundai Chen¹, Lei Gao¹

Affiliations

¹ Medical School of Chinese PLA, No. 28 Fuxing Road, Haidian District, Beijing 100853, China.
² Senior Department of Cardiology, Sixth Medical Center of Chinese PLA General Hospital, No. 6 Fucheng Road, Haidian District, Beijing 100853, China.
³ Department of Emergency, The First Medical Center, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China.

Abstract

Background: Previous studies have demonstrated that there are sex-related differences in atherosclerosis. However, in terms of the nature of in-stent restenosis (ISR) neointima, the effect of gender on the results is unclear.

Methods: Patients with ISR of drug-eluting stents (DES) who underwent OCT examination in Senior Department of Cardiology of the Chinese People's Liberation Army General Hospital from March 2010 to March 2022 were included. The patients were divided into male and female groups.

Results: In this study, a total of 230 DES-ISR patients and 249 DES-ISR target lesions were analyzed. OCT data showed that compared to females, males have a higher incidence of thin-cap fibrous atherosclerosis (TCFA) (37.4% [n = 77] vs. 9.3% [n = 4], p < 0.001) and in-stent neoatherosclerosis (ISNA) (82.0% [n = 169] vs. 62.8% [n = 27]). p = 0.005). In addition, a multivariate logistic regression analysis demonstrated that male was independently associated with a higher incidence of ISNA (OR: 2.659, 95% CI: 1.239-5.707; p = 0.012) and TCFA (OR: 4.216, 95% CI: 1.370-12.976; p = 0.012).

Conclusion: For DES-ISR patients, the incidence of ISNA in female was significantly lower than that in male and vulnerability of neointimal pattern is lower in female than in male.

Keywords: Drug-eluting stent; Gender; In-stent restenosis; Optical coherence tomography; Percutaneous coronary intervention.