: The prognostic value of abnormal resting Pd/Pa and coronary flow reserve (CFR) after fractional flow reserve (FFR)-guided revascularisation deferral according to sex remains unknown. From the ILIAS Registry composed of 20 hospitals globally from 7 countries, patients with deferred lesions following FFR assessment (FFR > 0.8) were included. (NCT04485234) The primary clinical endpoint was target vessel failure (TVF) at 2-years follow-up. We included 1392 patients with 1759 vessels (n = 564 women, 31.9%). Although resting Pd/Pa was similar between the sexes (p = 0.116), women had lower CFR than men (2.5 [2.0-3.2] vs. 2.7 [2.1-3.5]; p = 0.004). During a 2-year follow-up period, TVF events occurred in 56 vessels (3.2%). The risk of 2-year TVF was significantly higher in women with low versus high resting Pd/Pa (HR: 9.79; p < 0.001), whereas this trend was not seen in men. (Sex: P-value for interaction = 0.022) Furthermore, resting Pd/Pa provided an incremental prognostic value for 2-year TVF over CFR assessment only in women. After FFR-based revascularisation deferral, low resting Pd/Pa is associated with higher risk of TVF in women, but not in men. The predictive value of Pd/Pa increases when stratified according to CFR values, with significantly high TVF rates in women in whom both indices are concordantly abnormal.Clinical Trial Registration: Inclusive Invasive Physiological Assessment in Angina Syndromes Registry (ILIAS Registry), NCT04485234.
Abnormal physiological findings after FFR-based revascularisation deferral are associated with worse prognosis in women / Hoshino, Masahiro; van de Hoef, Tim P; Lee, Joo Myung; Hamaya, Rikuta; Kanaji, Yoshihisa; Boerhout, Coen K M; de Waard, Guus A; Jung, Ji-Hyun; Lee, Seung Hun; Mejia-Renteria, Hernan; Echavarria-Pinto, Mauro; Meuwissen, Martijn; Matsuo, Hitoshi; Madera-Cambero, Maribel; Eftekhari, Ashkan; Effat, Mohamed A; Marques, Koen; Doh, Joon-Hyung; Christiansen, Evald H; Banerjee, Rupak; Nam, Chang-Wook; Niccoli, Giampaolo; Murai, Tadashi; Nakayama, Masafumi; Tanaka, Nobuhiro; Shin, Eun-Seok; Sasano, Tetsuo; Appelman, Yolande; Beijk, Marcel; Knaapen, Paul; van Royen, Niels; Escaned, Javier; Koo, Bon Kwon; Piek, Jan J; Kakuta, Tsunekazu. - In: SCIENTIFIC REPORTS. - ISSN 2045-2322. - 13:1(2023), p. 1027. [10.1038/s41598-023-28146-6]
Abnormal physiological findings after FFR-based revascularisation deferral are associated with worse prognosis in women
Niccoli, Giampaolo;
2023-01-01
Abstract
: The prognostic value of abnormal resting Pd/Pa and coronary flow reserve (CFR) after fractional flow reserve (FFR)-guided revascularisation deferral according to sex remains unknown. From the ILIAS Registry composed of 20 hospitals globally from 7 countries, patients with deferred lesions following FFR assessment (FFR > 0.8) were included. (NCT04485234) The primary clinical endpoint was target vessel failure (TVF) at 2-years follow-up. We included 1392 patients with 1759 vessels (n = 564 women, 31.9%). Although resting Pd/Pa was similar between the sexes (p = 0.116), women had lower CFR than men (2.5 [2.0-3.2] vs. 2.7 [2.1-3.5]; p = 0.004). During a 2-year follow-up period, TVF events occurred in 56 vessels (3.2%). The risk of 2-year TVF was significantly higher in women with low versus high resting Pd/Pa (HR: 9.79; p < 0.001), whereas this trend was not seen in men. (Sex: P-value for interaction = 0.022) Furthermore, resting Pd/Pa provided an incremental prognostic value for 2-year TVF over CFR assessment only in women. After FFR-based revascularisation deferral, low resting Pd/Pa is associated with higher risk of TVF in women, but not in men. The predictive value of Pd/Pa increases when stratified according to CFR values, with significantly high TVF rates in women in whom both indices are concordantly abnormal.Clinical Trial Registration: Inclusive Invasive Physiological Assessment in Angina Syndromes Registry (ILIAS Registry), NCT04485234.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
