1. Sex Differences in Coronary Computed Tomography Angiography–Derived Fractional Flow Reserve
- Author
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Campbell Rogers, Tetsuya Amano, Gilbert L. Raff, Takashi Akasaka, Pamela S. Douglas, Timothy A. Fairbairn, Jeroen J. Bax, Lyne Hurwitz-Koweek, Bjarne L. Nørgaard, Niels Peter Rønnow Sand, Gianluca Pontone, Sukumaran Binukrishnan, Rebecca Dobson, Kavitha Chinnaiyan, Hironori Kitabata, Jonathon Leipsic, Koen Nieman, Daniel S. Berman, Manesh R. Patel, Mark G. Rabbat, Hitoshi Matsuo, and Tomohiro Kawasaki
- Subjects
coronary computed ,medicine.medical_specialty ,business.industry ,Coronary computed tomography angiography ,coronary volume/mass ,Fractional flow reserve ,030204 cardiovascular system & hematology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,fractional flow reserve derived from computed tomography ,medicine ,sex ,Radiology, Nuclear Medicine and imaging ,tomography angiography ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES This study is to determine the management and clinical outcomes of patients investigated with coronary computed tomography angiography (CCTA)-derived fractional flow reserve (FFRCT) according to sex.BACKGROUND Women are underdiagnosed with conventional ischemia testing, have lower rates of obstructive coronary artery disease (CAD) at invasive coronary angiography (ICA), yet higher mortality compared to men. Whether FFRCT improves sex-based patient management decisions compared to CCTA alone is unknown.METHODS Subjects with symptoms and CAD on CCTA were enrolled (2015 to 2017). Demographics, symptom status, CCTA anatomy, coronary volume to myocardial mass ratio (V/M), lowest FFRCT values, and management plans were captured. Endpoints included reclassification rate between CCTA and FFRCT management plans, incidence of ICA demonstrating obstructive CAD ($50% stenosis) and revascularization rates.RESULTS A total of 4,737 patients (n = 1,603 females, 33.8%) underwent CCTA and FFRCT. Women were older (age 68 +/- 10 years vs. 65 +/- 10 years; p < 0.0001) with more atypical symptoms (41.5% vs. 33.9%; p < 0.0001). Women had less obstructive CAD (65.4% vs. 74.7%; p < 0.0001) at CCTA, higher FFRCT (0.76 +/- 0.10 vs. 0.73 +/- 0.10; p < 0.0001), and lower likelihood of positive FFRCT
- Published
- 2020
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