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oai:repisalud.isciii.es:20.500.12105/94412024-09-27T08:13:05Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605

00925njm 22002777a 4500 dc Hoshino, Masahiro author Hamaya, Rikuta author Kanaji, Yoshihisa author Kanno, Yoshinori author Hada, Masahiro author Yamaguchi, Masao author Sumino, Yohei author Hirano, Hidenori author Horie, Tomoki author Usui, Eisuke author Sugiyama, Tomoyo author Murai, Tadashi author Lee, Tetsumin author Yonetsu, Taishi author Lee, Joo Myung author Choi, Ki Hong author Hwang, Doyeon author Park, Jonghanne author Jung, Ji-Hyun author Kim, Hyung Yoon author Jung, Hae Won author Cho, Yun-Kyeong author Yoon, Hyuck-Jun author Song, Young Bin author Hahn, Joo-Yong author Doh, Joon Hyung author Nam, Chang Wook author Shin, Eun Seok author Hur, Seung-Ho author Mejía-Rentería, Hernán author Lauri, Francesco author Goto, Sonoka author Macaya, Fernando author McInerney, Angela author Gravina, Giacomo author Vera, Rafael author Gonzalo, Nieves author Jimenez-Quevedo, Pilar author Nuñez-Gil, Ivan author Salinas, Pablo author Nombela-Franco, Luis author Del Trigo, Maria author Fernandez-Ortiz, Antonio author Macaya, Carlos author Koo, Bon-Kwon author Escaned, Javier author Kakuta, Tsunekazu author 2020-02-18 Background Sex-specific differences may influence prognosis after deferred revascularization following fractional flow reserve (FFR) measurement. This study sought to investigate the sex differences in long-term prognosis of patients with deferred revascularization following FFR assessment. Methods and Results A total of 879 patients (879 vessels) with deferred revascularization with FFR >0.75 who underwent FFR and coronary flow reserve measurements were enrolled from 3 countries (Korea, Japan, and Spain). Long-term outcomes were assessed in 649 men and 230 women by the patient-oriented composite outcome (POCO, a composite of any death, any myocardial infarction, and any revascularization). We applied inverse-probability weighting based on propensity scores to account for differences at baseline between women and men (age, hyperlipidemia, diabetes mellitus, diameter stenosis, lesion length, multivessel disease, FFR, coronary flow reserve. The median follow-up duration was 1855 days (745-1855 days). Median FFR values were 0.88 (0.83-0.93) in men and 0.89 (0.85-0.94) in women, respectively. The occurrences of POCO were significantly high in men compared with that in women (10.5% versus 4.2%, P=0.007). Kaplan-Meier analysis revealed that women had a significantly lower risk of POCO (χ2=7.2, P=0.007). Multivariate COX proportional hazards regression analysis revealed that age, male, diabetes mellitus, diameter stenosis, lesion length, and coronary flow reserve were independent predictors of POCO. After applying IPW, the hazard ratio of males for POCO was 2.07 (95% CI, 1.07-4.04, P=0.032). Conclusions This large multinational study reveals that long-term outcome differs between women and men in favor of women after FFR-guided revascularization deferral. Clinical Trial Registration URL: http://www.ClinicalTrials.gov. Unique identifier: NCT02186093. J Am Heart Assoc. 2020; 9(4):e014458 10.1161/JAHA.119.014458 2047-9980 2047-9980 Journal of the American Heart Association 32063120 http://hdl.handle.net/20.500.12105/9441 Coronary flow reserve Fractional flow reserve Microvascular dysfunction Sex differences Sex Differences in Long-Term Outcomes in Patients With Deferred Revascularization Following Fractional Flow Reserve Assessment: International Collaboration Registry of Comprehensive Physiologic Evaluation