Author:
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
Abstract
AbstractThe 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. (NCT 04485234) 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.
Publisher
Springer Science and Business Media LLC