Author + information
- Rutger van Bommel1,
- Roberto Diletti2,
- Miguel Lemmert3,
- Jeroen Wilschut3,
- Peter P.T. De Jaegere4,
- Felix Zijlstra5,
- Joost Daemen6 and
- Nicolas Van Mieghem7
- 1Erasmus MC, Rotterdam, Netherlands
- 2Thorax Center, Erasmus MC, Rotterdam, Netherlands
- 3Thoraxcenter Erasmus MC, Rotterdam, Netherlands
- 4Erasmus MC, Rotterdam, The Netherlands, Rotterdam, Netherlands
- 5Thoraxcenter, Erasmus Medical Centre, Rotterdam, Netherlands
- 6Erasmus MC - Thoraxcenter, United States
- 7Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherland
Recent studies have shown that women have higher FFR values than men when FFR is used to assess the hemodynamic severity of an intermediate coronary stenosis. This is most likely caused by microvascular dysfunction which is more frequently observed in women. Conversely, not much is known about gender specific differences in FFR values after PCI. Therefore, the aims of the current study were to investigate whether differences exist in FFR after successful PCI in men vs. women and whether there is a difference in outcome during 30-days follow-up.
The FFR SEARCH study is a prospective registry in which all consecutive patients underwent FFR evaluation after successful PCI. FFR measurements were performed with a novel over-the-wire monorail catheter inserted over the previously used coronary guidewire to approximately 20mm distal of the most distal stent edge. FFR measurements were performed under maximum hyperaemia with intravenous Adenosine.
A total of 959 patients (695 men and 264 women) were included with 1165 successfully treated and measured lesions. Overall, mean FFR value was 0.91±0.07 under maximum hyperaemia. No significant differences were observed in absolute post PCI FFR values (0.91±0.06 in women vs. 0.90±0.07 in men, p=0.135). However, a post PCI FFR value ≤0.85 was much more frequently observed in men (n=173, 24.9%) than in women (n=40, 15.2%), p=0.001. In 798 patients, complete 30-days follow-up was achieved. In this period, 15 patients (1.9%) experienced a MACE. There were no differences in MACE-rate between men and women (1.9% vs 1.8%, p=0.903).
An FFR value ≤0.85 measured directly following successful PCI was more frequently observed in men than in women. This may be indicative of microvascular dysfunction which is more common in women. Conversely, no differences in 30-days outcome were observed between men and women.
IMAGING: FFR and Physiologic Lesion Assessment