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Gender differences in long-term outcomes in patients with deferred revascularization following fractional flow reserve assessment: International Collaboration Registry of Comprehensive Physiologic Evaluation

Journal of the American Heart Association Feb 26, 2020

Hoshino M, Hamaya R, Kanaji Y, et al. - Given a possible impact of gender-specific variations on prognosis following deferred revascularization after fractional flow reserve (FFR) measurement, researchers inquired the gender disparities in the long-term prognosis of patients with deferred revascularization after FFR evaluation. Overall, 879 patients (879 vessels) with deferred revascularization with FFR > 0.75 who had FFR and coronary flow reserve measurements, recruited from 3 countries (Korea, Japan, and Spain), were enrolled. In 649 males and 230 females, evaluation of long-term outcomes was done by the patient-oriented composite outcome (POCO, a composite of any death, any myocardial infarction, and any revascularization). Men vs women had significantly high occurrences of POCO (10.5% vs 4.2%). In Kaplan–Meier analysis, a significantly lower risk of POCO was noted in women. Independent predictors of POCO that were identified in multivariate COX proportional hazards regression analysis were: age, male, diabetes mellitus, diameter stenosis, lesion length, and coronary flow reserve. The hazard ratio of males for POCO, following IPW application, was estimated to be 2.07. In this large multinational investigation, findings showed that long-term result varied between women and men in favor of women following FFR-guided revascularization deferral.
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