Effect of a change in gender on coronary arterial size

Herity, Niall A.; Lo, S.; Lee, David P.; Ward, Michael R.; Filardo, Steven D.; Yock, Paul G.; Fitzgerald, Peter J.; Hunt, Sharon A.; Yeung, Alan C.

doi:10.1016/s0735-1097(03)00246-8

Cited by 37 publications

(14 citation statements)

References 27 publications

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“…28 Various interpretations of these differences, ranging from biological factors (women's vascular structural features, postmenopausal loss of the estrogen stimulating effect on circulating endothelial progenitor cells) to provider preferences, have been suggested. 32 , 33 The similar rates of STEMI PCI in men and women in this study contrast with the lower rate for NSTEMI PCI for women and suggest that sex-related differences in the coronary vascular atherosclerotic expression might be involved not only in this AMI PCI sex disparity but also in the differences in CABG procedures. Indeed, similar cath rates between men and women in this study suggest that the significant differences in revascularization procedures may have been determined by findings of different coronary vascular characteristics by the operators, although it is uncertain to what extent they may have been also driven by choices related to sex differences in comorbidities or patients' preferences.…”

Section: Influence Of Race/ethnicity In Acute Myocardial Infarction Omentioning

confidence: 53%

Sex Differences in Acute Myocardial Infarction Hospital Management and Outcomes

2018

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Section: Influence Of Race/ethnicity In Acute Myocardial Infarction Omentioning

confidence: 53%

Sex Differences in Acute Myocardial Infarction Hospital Management and Outcomes

2018

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“…It might be partly related to the sex difference in the relative frequencies of myocardial infarction and stroke as illustrated in the placebo group of the 2 large American trials [20, 22]: stroke was much more frequent (34/100,000/year) than myocardial infarction (97/100,000/year) in women, whereas myocardial infarction was far more frequent (439.7) than stroke (179.4) in men, the 2 populations being of similar age [24]. Other potential factors include differences in vascular anatomy, such as smaller coronary arteries in women [26], in the distribution of carotid atheroma [27], in vascular reactivity [28] or in the lowest effective dose of aspirin. Is there a huge overlooked bias underlying this puzzle?…”

Section: Translations Of Results From Men To Womenmentioning

confidence: 99%

Some Translations in Vascular Neurology

Bousser¹

2008

Cerebrovasc Dis

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‘Translation’ in medicine immediately suggests ‘translational research’, but there are many other varieties of ‘translation’. I have selected 4 translations in the field of vascular neurology in which I have been involved in different respects: (1) the translation of results from men to women, taking the example of aspirin which, in primary prevention, decreases the risk of myocardial infarction in men and the risk of cerebral infarction in women, the reason for this sex difference being so far unknown; (2) the ‘inverse translational research’, from bedside to bench, taking the example of the disease we have identified – CADASIL – and showing how the study of one patient and his family led to the identification of a gene, Notch3, so far unknown in humans and to the discovery of its key role in the physiology of vascular smooth muscle cells; (3) the translation from individual case reports to multidisciplinary trials taking the example of hemicraniectomy in malignant cerebral infarction and emphasizing the interest in such rare and severe conditions of pooling and reporting the results of randomized clinical trials before the results of individual trials, and (4) the translation from research to practice, emphasizing not the well-known ‘evidence to practice gap’ but the slippery slope of ‘lack of evidence to overpractice’, taking the example of patent foramen ovale closure in migraine.

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“…The sow in this report was part of a pre-clinical vascular study. Although clinically several sex-related differences in cardiovascular anatomy, pathophysiology and intervention response have been identified (60)(61)(62), sex is rarely evaluated in short-term pre-clinical animal models as a confounding variable. In 2018 Kunio et al (63) examined the sex-related differences in the outcome of endovascular stent implantation in swine.…”

Section: Discussionmentioning

confidence: 99%

Fatal Ovarian Hemorrhage Associated With Anticoagulation Therapy in a Yucatan Mini-Pig Following Venous Stent Implantation

et al. 2020

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Swine models are commonly utilized in endovascular research for development of intravascular interventions and medical device development. As part of a pilot study for a venous vascular stent device, a 5-year-old female Yucatan mini-pig underwent bilateral external iliac vein stent placement under general anesthesia. To reduce thrombotic complications by reduction of thrombus formation on wires, sheaths, and catheters, the pig was heparinized with a total of 300 IU/kg of heparin, establishing an activated clotting time (ACT) of 436 s. The ACT had returned to below 200 s by the end of the procedure. To prevent postoperative thrombosis, the pig received an anticoagulation therapy protocol consisting of enoxaparin, clopidogrel, and aspirin. There were no complications during the immediate postoperative period. However, the pig died 4 days after surgery. Necropsy established the cause of death as abdominal exsanguination due to severe, acute, intra-ovarian hemorrhage, most likely related to ovulation. Life-threatening ovarian hemorrhage is occasionally seen in women with congenital or acquired bleeding disorders; to our knowledge this is the first report of fatal ovarian hemorrhage in an animal enrolled in a pre-clinical research trial.

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Effect of a change in gender on coronary arterial size

Abstract: This pattern of arterial remodeling early after heart transplantation supports a link between host gender and coronary arterial size.

Cited by 37 publications

References 27 publications

Sex Differences in Acute Myocardial Infarction Hospital Management and Outcomes

Sex Differences in Acute Myocardial Infarction Hospital Management and Outcomes

Some Translations in Vascular Neurology

Fatal Ovarian Hemorrhage Associated With Anticoagulation Therapy in a Yucatan Mini-Pig Following Venous Stent Implantation

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