Alkhalil M, Thomas G, Spence MS, et al. - The study demonstrates a sex-based difference in fractional flow reserve (FFR), particularly in stenoses subtending large myocardium, and more evident in deferred lesions.

• The results showed that in 1,554 lesions (23% in women), FFR was lower in men [0.83 ±0.09 vs. 0.85 ±0.08, P=0.004] driven by LAD values (for LAD P<0.001, LCx or RCA P> 0.40).

• In proximal lesions (PLs), they observed low FFR in men [0.83 ±0.10 vs. 0.85 ±0.08, P=0.004] with comparable values in non-PLs [0.84 ±0.09 vs. 0.85 ±0.08, P= 0.36].

• In PLs, the study found higher primary endpoints in women [HR(adjusted) 3.18 (1.08-9.37), P=0.035] with comparable outcomes in non-PLs (P=0.032 for interaction).

• In deferred lesions, in women, the primary endpoint was higher [HR(adjusted) 2.73 (1.10-6.74), P=0.03] with no differences in revascularized lesions across gender (P=0.02 for interaction).

• They observed consistent outcomes when using propensity score matching analysis.