Author + information
- Chee Hae Kim1,
- Jonghanne Park2,
- Ki Hong Choi3,
- Joo Myung Lee4,
- Jung-Kyu Han1,
- Han-Mo Yang5,
- Kyung Woo (KW) Park1,
- Hyun-Jae Kang1,
- Hyo-Soo Kim1 and
- Bon-Kwon Koo1
- 1Seoul National University Hospital, Seoul, Korea, Republic of
- 2Ministry of Health and Welfare, Seoul, Korea, Republic of
- 3Samsung Medical Center, Seoul, Korea, Republic of
- 4Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of
- 5Seoul National University Hospital, seoul, Korea, Republic of
It is known that fractional flow reserve (FFR) values tend to be higher in women than in men. However, it is not clear whether this sex difference is observed in all coronary vessels and whether the same criteria can be used for FFR-guided PCI.
A pooled population of Korean 4-Centers registry and 3-vessel FFR FRIENDS registry (3V FFR-FRIENDS study, NCT01621438) was used for this study. Total 2,446 patients (female 733 patients, 30.0%) with 4,900 vessels were analyzed. The difference in FFR value between female and male was investigated by vessels. The primary endpoint was major adverse cardiovascular outcome (MACE, a composite of cardiac death, myocardial infarction and ischemia-driven revascularization) at 2 years.
There was no difference in percent diameter stenosis between female and male (48.1±19.2% vs. 47.7±19.5%, p=0.588), but FFR was higher in female (0.87±0.11 vs. 0.86±0.12, p=0.002). Analyzing by lesion location, FFR difference mainly occurred in left anterior descending artery (LAD, 0.82±0.10 vs. 0.79±0.12, p<0.001), but not in left circumflex (LCX, 0.91±0.10 vs. 0.91±0.09, p=0.728) or right coronary artery (RCA, 0.91±0.10 vs. 0.91±0.10, p=0.260) (Figure). There was no sex difference in 2-year MACE rate in deferred lesions based on FFR cut-off value of 0.80 (1.3% vs. 1.8%, HR 0.734, 95% CI 0.385-1.1.399, p=0.347).
The difference in FFR values between female and male was predominantly due to LAD. Although there was a difference in FFR values, the clinical outcomes of deferred lesion based on FFR 0.80 was similar in female and male.
IMAGING: FFR and Physiologic Lesion Assessment