{rfName}
Se

Indexed in

License and use

Citations

5

Altmetrics

Analysis of institutional authors

Alfonso, FAuthor

Share

July 20, 2023
Publications
>
Article
No

Sex-specific features of optical coherence tomography detected plaque vulnerability related to clinical outcomes: insights from the CLIMA study

Publicated to:INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING. 39 (4): 873-881 - 2022-12-19 39(4), DOI: 10.1007/s10554-022-02775-w

Authors: Biccire, Flavio Giuseppe; Debelak, Caterina; Varricchione, Giuseppe; Budassi, Simone; Gatto, Laura; Romagnoli, Enrico; Di Pietro, Riccardo; Sammartini, Emanuele; Marco, Valeria; Paoletti, Giulia; Burzotta, Francesco; Ozaki, Yukio; Pastori, Daniele; Alfonso, Fernando; Arbustini, Eloisa; Prati, Francesco;

Affiliations

Abstract

To investigate the different impact of optical coherence tomography (OCT)-derived vulnerable plaque features on future adverse events (AEs) according to the biological sex.The prospective multicenter CLIMA study (ClinicalTrials.gov: NCT02883088) enrolled 1003 patients with OCT plaque analysis of non-treated coronary plaques located in the proximal left anterior descending artery. Sex-specific differences in plaque composition and vulnerable features were described. We investigated the incidence of AEs, including cardiac death, any myocardial infarction and target vessel revascularization at 1-year.Among 1003 patients, 24.6% were women. Women were older and more frequently affected by chronic kidney disease. Dyslipidemia, prior MI and smoking habit were more common in men. At OCT analysis, women had shorter plaque length (p < 0.001), ticker fibrous cap (p = 0.001), smaller maximum lipid arc (p = 0.019), lower macrophage infiltration (p < 0.001) and intra-plaque layered tissue (p = 0.007). During follow-up, 65 AEs were registered. The presence of a thin fibrous cap and a large macrophage infiltration (> 67°) predicted AEs in both sexes. The presence of macrophages (HR 3.38, p = 0.018) and a small minimum lumen area (HR 4.97, p = 0.002) were associated with AEs in women but not in men, while a large lipid arc (> 180°) was associated with AEs in men (HR 2.56, p = 0.003) but not in women.This subanalysis of the CLIMA study investigated for the first-time sex-specific OCT features of plaque vulnerability associated with AEs. Local inflammation was associated with AEs in women and a large lipid arc was predictive in men. OCT may help develop sex-specific risk stratification strategies.© 2022. The Author(s), under exclusive licence to Springer Nature B.V.

Keywords

cardiovascular riskgender differencesoptical coherence tomographyprognosissex differencesVulnerable plaque

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2022, it was in position , thus managing to position itself as a Q2 (Segundo Cuartil), in the category Radiology, Nuclear Medicine and Imaging. Notably, the journal is positioned en el Cuartil Q3 for the agency WoS (JCR) in the category Radiology, Nuclear Medicine & Medical Imaging.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 1.96, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-22, the following number of citations:

  • WoS: 2

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-22:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 3.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 3 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 1.85.
  • The number of mentions on the social network X (formerly Twitter): 2 (Altmetric).