Abnormal physiological findings after FFR-based revascularisation deferral are associated with worse prognosis in women

Masahiro Hoshino, Tim P van de Hoef, Joo Myung Lee, Rikuta Hamaya, Yoshihisa Kanaji, Coen K M Boerhout, Guus A de Waard, Ji-Hyun Jung, Seung Hun Lee, Hernan Mejia-Renteria, Mauro Echavarria-Pinto, Martijn Meuwissen, Hitoshi Matsuo, Maribel Madera-Cambero, Ashkan Eftekhari, Mohamed A Effat, Koen Marques, Joon-Hyung Doh, Evald H Christiansen, Rupak BanerjeeChang-Wook Nam, Giampaolo Niccoli, Tadashi Murai, Masafumi Nakayama, Nobuhiro Tanaka, Eun-Seok Shin, Tetsuo Sasano, Yolande Appelman, Marcel Beijk, Paul Knaapen, Niels van Royen, Javier Escaned, Bon Kwon Koo, Jan J Piek, Tsunekazu Kakuta

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The 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. (NCT04485234) 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.

Original languageEnglish
Article number1027
Pages (from-to)1027
JournalScientific Reports
Volume13
Issue number1
DOIs
Publication statusPublished - 19 Jan 2023
Externally publishedYes

Keywords

  • Cardiac Catheterization
  • Coronary Angiography
  • Coronary Artery Disease/diagnosis
  • Coronary Stenosis
  • Coronary Vessels
  • Female
  • Fractional Flow Reserve, Myocardial/physiology
  • Humans
  • Male
  • Predictive Value of Tests
  • Prognosis
  • Treatment Outcome

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