Gender characteristics of atherosclerotic lesions of carotid arteries HTML

Authors: N.I. Glushkov, M.A. Ivanov, A.S. Artemova, A.D. Gorovaya, A.A. Uryupina

Company: North-Western State Medical University named after I.I. Mechnikov of Ministry of Health of the Russian Federation, Piskarevskiy prospect, 47, Saint-Petersburg, 195076, Russian Federation

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Heading: Original articles

UDC: 616.133-004.6
DOI: https://doi.org/0.24022/1997-3187-2019-13-1-8-16

For citation: Glushkov N.I., Ivanov M.A., Artemova A.S., Gorovaya A.D., Uryupina A.A. Gender characteristics of atherosclerotic lesions of carotid arteries. Creative Cardiology. 2019; 13 (1): 8–16 (in Russ.). DOI: 10.24022/ 1997-3187-2019-13-1-8-16

Received / Accepted:  04.02.2019/07.02.2019

Key Words: carotid endarterectomy gender differences

Abstract

Objective. To study the gender characteristics of atherosclerotic lesions of the carotid arteries, as well as the results of carotid endarterectomy.

Material and methods. The course of atherosclerotic lesions of the carotid arteries was studied in 88 patients. The patients were divided into 2 groups by gender: 21 female patients were included in the main group, 67 male patients made up the control group. Analyzed metabolic abnormalities (glucose level, lipid spectrum), blood pressure level before surgery, especially atherosclerotic lesions of the brachiocephalic arteries. All patients underwent carotid endarterectomy. The course of the postoperative period, the presence of complications (development of transient ischemic attacks, ischemic stroke, atrial fibrillation) in the early postoperative period and long-term periods up to 5 years were analyzed.

Results. The atherosclerotic process in women was characterized by more pronounced metabolic changes and perioperative hemodynamic instability: diabetes mellitus was more common in females (42.9% vs. 14.9, p<0.05), the level of total cholesterol was higher in women (6.4±0.5 mmol/l vs. 6.1±0.77; p<0.05). The intraoperative systolic pressure fluctuations were 54.4±9.8 mm Hg in women and 42.6±19.7 mmHg in men (p<0.05). The early postoperative period was characterized by hemodynamic instability on the first day in females: the maximum systolic blood pressure in women was 185.3±21.1 and 159.1±23.5 mm Hg in men (p=0.004); more pronounced fluctuations in systolic blood pressure were characteristic of women (82.5±33.9 mm Hg vs. 44.9±16.3, p=0.0001). Complications were more common in females at early stages after surgery: atrial fibrillation was recorded in 2 (9.5%) patients, in males this complication was not recorded (p<0.05), transient ischemic attacks in the early stages after surgery, 1 (1.5%) man and 1 (4.8%) woman (p=0.38) were recorded; acute cerebral circulation was detected early in 1 female patient (p=0.2).

Conclusion. Patients with atherosclerotic lesions of the carotid arteries are characterized by more pronounced metabolic disorders (presence and severity of carbohydrate metabolism disorders, changes in the blood lipid spectrum) compared with men, which could affect the incidence of postoperative complications in females.

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About Authors

  • Nikolay I. Glushkov, Dr Med. Sc., Professor, Chief of Chair, orcid.org/0000-0001-8146-4728;
  • Mikhail A. Ivanov, Dr Med. Sc., Professor, orcid.org/0000-0002-9966-8697;
  • Anastasiya S. Artemova, Resident Physician, orcid.org/0000-0002-3773-6762;
  • Anastasiya D. Gorovaya, Student, orcid.org/0000-0002-6817-028X;
  • Anastasiya A. Uryupina, Student, orcid.org/0000-0002-4386-6563

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery