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Effect of menopause on plaque morphologic characteristics in coronary atherosclerosis.

Abstract：

BACKGROUND:Coronary artery disease in women appears 10 to 15 years later than in men. To test the hypothesis that the effects of estrogen may manifest themselves as histologic differences in coronary plaques, we examined the hearts of premenopausal and postmenopausal women who died suddenly from coronary artery disease. METHODS:We studied 51 cases of sudden coronary death and 47 deaths in women who died from noncoronary causes. Coronary deaths were classified on the basis of histologic features. The number of acute plaque ruptures, healed plaque ruptures, vulnerable plaques, and acute plaque erosions were compared between groups. Postmortem values of serum total cholesterol, HDL cholesterol, and thiocyanate were measured, and menopausal status was confirmed by calculating body mass index. RESULTS:Women older than 50 years of age were much more likely to have a ruptured plaque than were younger, premenopausal women. Plaque rupture was significantly associated with elevated total cholesterol level. In the 51 women who died of coronary disease, the mean number of vulnerable plaques increased significantly as women advanced into the postmenopausal years. CONCLUSIONS:Our data suggest that estrogen has an anti-inflammatory effect on atherosclerotic plaques, resulting in plaque stabilization. Plaque erosion, the major substrate for thrombosis in premenopausal women, does not appear to be inhibited by estrogen. Because plaque progression may result both from repeated rupture and repeated erosion, a better understanding of the effect of estrogen on atherosclerosis may yield insights into the nature of coronary artery disease.

journal_name

Am Heart J

journal_title

American heart journal

authors

Burke AP,Farb A,Malcom G,Virmani R

doi

10.1067/mhj.2001.109946

subject

Has Abstract

pub_date

2001-02-01 00:00:00

pages

S58-62

issue

2 Suppl

eissn

0002-8703

issn

1097-6744

pii

a109946

journal_volume

141

pub_type

杂志文章

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