Back to Search
Start Over
Sex Differences in Instantaneous Wave-Free Ratio or Fractional Flow Reserve–Guided Revascularization Strategy
- Source :
- JACC. Cardiovascular Interventions, 12, 2035-2046, JACC : cardiovascular interventions, JACC: Cardiovascular Interventions, 12(20), 2035-2046. Elsevier Inc., JACC. Cardiovascular interventions, 12(20), 2035-2046. Elsevier Inc., Kim, C H, Koo, B-K, Dehbi, H-M, Lee, J M, Doh, J-H, Nam, C-W, Shin, E-S, Cook, C M, Al-Lamee, R, Petraco, R, Sen, S, Malik, I S, Nijjer, S S, Mejía-Rentería, H, Alegria-Barrero, E, Alghamdi, A, Altman, J, Baptista, S R B, Bhindi, R, Bojara, W, Brugaletta, S, Silva, P C, di Mario, C, Erglis, A, Gerber, R T, Going, O, Härle, T, Hellig, F, Indolfi, C, Janssens, L, Jeremias, A, Kharbanda, R K, Khashaba, A, Kikuta, Y, Krackhardt, F, Laine, M, Lehman, S J, Matsuo, H, Meuwissen, M, Niccoli, G, Piek, J J, Ribichini, F, Samady, H, Sapontis, J, Seto, A H, Sezer, M, Sharp, A S P, Singh, J, Takashima, H, Talwar, S, Tanaka, N, Tang, K, van Belle, E, van Royen, N, Vinhas, H, Vrints, C J, Walters, D, Yokoi, H, Samuels, B, Buller, C, Patel, M R, Serruys, P W, Escaned, J & Davies, J E 2019, ' Sex Differences in Instantaneous Wave-Free Ratio or Fractional Flow Reserve–Guided Revascularization Strategy ', JACC: Cardiovascular Interventions, vol. 12, no. 20, pp. 2035-2046 . https://doi.org/10.1016/j.jcin.2019.06.035, JACC. Cardiovascular Interventions, 12, 20, pp. 2035-2046, Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos), Agência para a Sociedade do Conhecimento (UMIC)-FCT-Sociedade da Informação, instacron:RCAAP
- Publication Year :
- 2019
-
Abstract
- Item does not contain fulltext OBJECTIVES: This study sought to evaluate sex differences in procedural characteristics and clinical outcomes of instantaneous wave-free ratio (iFR)- and fractional flow reserve (FFR)-guided revascularization strategies. BACKGROUND: An iFR-guided strategy has shown a lower revascularization rate than an FFR-guided strategy, without differences in clinical outcomes. METHODS: This is a post hoc analysis of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate stenosis to guide Revascularization) study, in which 601 women and 1,891 men were randomized to iFR- or FFR-guided strategy. The primary endpoint was 1-year major adverse cardiac events (MACE), a composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization. RESULTS: Among the entire population, women had a lower number of functionally significant lesions per patient (0.31 +/- 0.51 vs. 0.43 +/- 0.59; p < 0.001) and less frequently underwent revascularization than men (42.1% vs. 53.1%; p < 0.001). There was no difference in mean iFR value according to sex (0.91 +/- 0.09 vs. 0.91 +/- 0.10; p = 0.442). However, the mean FFR value was lower in men than in women (0.83 +/- 0.09 vs. 0.85 +/- 0.10; p = 0.001). In men, an FFR-guided strategy was associated with a higher rate of revascularization than an iFR-guided strategy (57.1% vs. 49.3%; p = 0.001), but this difference was not observed in women (41.4% vs. 42.6%; p = 0.757). There was no difference in MACE rates between iFR- and FFR-guided strategies in both women (5.4% vs. 5.6%, adjusted hazard ratio: 1.10; 95% confidence interval: 0.50 to 2.43; p = 0.805) and men (6.6% vs. 7.0%, adjusted hazard ratio: 0.98; 95% confidence interval: 0.66 to 1.46; p = 0.919). CONCLUSIONS: An FFR-guided strategy was associated with a higher rate of revascularization than iFR-guided strategy in men, but not in women. However, iFR- and FFR-guided strategies showed comparable clinical outcomes, regardless of sex. (Functional Lesion Assessment of Intermediate Stenosis to guide Revascularization [DEFINE-FLAIR]; NCT02053038).
- Subjects :
- Male
Cardiac Catheterization
Time Factors
medicine.medical_treatment
clinical outcome
MICROVASCULAR DYSFUNCTION
Fractional flow reserve
Coronary Artery Disease
030204 cardiovascular system & hematology
GUIDELINES
ANGIOGRAPHY
Percutaneous coronary intervention
0302 clinical medicine
Recurrence
Risk Factors
Cause of Death
Clinical endpoint
ARTERY-DISEASE
030212 general & internal medicine
Myocardial infarction
fractional flow reserve
Vascular damage Radboud Institute for Molecular Life Sciences [Radboudumc 16]
ASSOCIATION
Middle Aged
Coronary Vessels
Fractional Flow Reserve, Myocardial
Treatment Outcome
Cardiology
Female
Sex factors
Cardiology and Cardiovascular Medicine
medicine.medical_specialty
INDEXES
PERCUTANEOUS CORONARY INTERVENTION
PRESSURE
Revascularization
STENOSIS
03 medical and health sciences
Sex Factors
Predictive Value of Tests
Internal medicine
medicine
sex
Humans
Instantaneous wave-free ratio
Acute Coronary Syndrome
Healthcare Disparities
instantaneous wave-free ratio
Aged
business.industry
Myocardial fractional flow reserve
Coronary Stenosis
Health Status Disparities
medicine.disease
Stenosis
SEVERITY
3121 General medicine, internal medicine and other clinical medicine
ST Elevation Myocardial Infarction
Human medicine
business
Mace
Subjects
Details
- Language :
- English
- ISSN :
- 19368798
- Volume :
- 12
- Issue :
- 20
- Database :
- OpenAIRE
- Journal :
- JACC: Cardiovascular Interventions
- Accession number :
- edsair.doi.dedup.....496e9869e57994add4cc05063e1511b8