Sex Differences in Instantaneous Wave-Free Ratio or Fractional Flow Reserve–Guided Revascularization Strategy
| Autor: | Chee Hae Kim, Ali Alghamdi, Sayan Sen, Chang-Wook Nam, Kare Tang, Eduardo Alegría-Barrero, Andrew S.P. Sharp, Javier Escaned, Flavo Ribichini, Allen Jeremias, Patrick W. Serruys, John D. Altman, Hiroyoshi Yokoi, Salvatore Brugaletta, Iqbal S. Malik, Murat Sezer, Christopher Cook, Waldemar Bojara, Hugo Vinhas, Carlo Di Mario, Christiaan J. Vrints, Suneel Talwar, Ciro Indolfi, Pedro Canas da Silva, Hernán Mejía-Rentería, Yuetsu Kikuta, Arnold H. Seto, Bruce Samuels, Jan J. Piek, Rasha Al-Lamee, Hitoshi Matsuo, Luc Janssens, Mika Laine, Olaf Going, Rajesh K. Kharbanda, Robert Gerber, Joo Myung Lee, Hakim-Moulay Dehbi, Justin E. Davies, Tobias Härle, Niels van Royen, Nobuhiro Tanaka, Sérgio Bravo Baptista, James Sapontis, Ricardo Petraco, Sukhjinder Nijjer, Ahmed Khashaba, Bon Kwon Koo, Manesh R. Patel, Christopher E. Buller, Eric Van Belle, Giampaolo Niccoli, Martijin Meuwissen, Farrel Hellig, Hiroaki Takashima, Andrejs Erglis, Eun-Seok Shin, Habib Samady, Darren L. Walters, Florian Krackhardt, Jasvindar Singh, Ravinay Bhindi, Sam J. Lehman, Joon Hyung Doh |
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| Přispěvatelé: | Cardiology, ACS - Atherosclerosis & ischemic syndromes, HUS Heart and Lung Center, Kardiologian yksikkö, ACS - Microcirculation |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Cardiac Catheterization Time Factors medicine.medical_treatment clinical outcome MICROVASCULAR DYSFUNCTION Fractional flow reserve Coronary Artery Disease 030204 cardiovascular system & hematology GUIDELINES ANGIOGRAPHY Percutaneous coronary intervention 0302 clinical medicine Recurrence Risk Factors Cause of Death Clinical endpoint ARTERY-DISEASE 030212 general & internal medicine Myocardial infarction fractional flow reserve Vascular damage Radboud Institute for Molecular Life Sciences [Radboudumc 16] ASSOCIATION Middle Aged Coronary Vessels Fractional Flow Reserve Myocardial Treatment Outcome Cardiology Female Sex factors Cardiology and Cardiovascular Medicine medicine.medical_specialty INDEXES PERCUTANEOUS CORONARY INTERVENTION PRESSURE Revascularization STENOSIS 03 medical and health sciences Sex Factors Predictive Value of Tests Internal medicine medicine sex Humans Instantaneous wave-free ratio Acute Coronary Syndrome Healthcare Disparities instantaneous wave-free ratio Aged business.industry Myocardial fractional flow reserve Coronary Stenosis Health Status Disparities medicine.disease Stenosis SEVERITY 3121 General medicine internal medicine and other clinical medicine ST Elevation Myocardial Infarction Human medicine business Mace |
| Zdroj: | JACC. Cardiovascular Interventions, 12, 2035-2046 JACC : cardiovascular interventions JACC: Cardiovascular Interventions, 12(20), 2035-2046. Elsevier Inc. JACC. Cardiovascular interventions, 12(20), 2035-2046. Elsevier Inc. Kim, C H, Koo, B-K, Dehbi, H-M, Lee, J M, Doh, J-H, Nam, C-W, Shin, E-S, Cook, C M, Al-Lamee, R, Petraco, R, Sen, S, Malik, I S, Nijjer, S S, Mejía-Rentería, H, Alegria-Barrero, E, Alghamdi, A, Altman, J, Baptista, S R B, Bhindi, R, Bojara, W, Brugaletta, S, Silva, P C, di Mario, C, Erglis, A, Gerber, R T, Going, O, Härle, T, Hellig, F, Indolfi, C, Janssens, L, Jeremias, A, Kharbanda, R K, Khashaba, A, Kikuta, Y, Krackhardt, F, Laine, M, Lehman, S J, Matsuo, H, Meuwissen, M, Niccoli, G, Piek, J J, Ribichini, F, Samady, H, Sapontis, J, Seto, A H, Sezer, M, Sharp, A S P, Singh, J, Takashima, H, Talwar, S, Tanaka, N, Tang, K, van Belle, E, van Royen, N, Vinhas, H, Vrints, C J, Walters, D, Yokoi, H, Samuels, B, Buller, C, Patel, M R, Serruys, P W, Escaned, J & Davies, J E 2019, ' Sex Differences in Instantaneous Wave-Free Ratio or Fractional Flow Reserve–Guided Revascularization Strategy ', JACC: Cardiovascular Interventions, vol. 12, no. 20, pp. 2035-2046 . https://doi.org/10.1016/j.jcin.2019.06.035 JACC. Cardiovascular Interventions, 12, 20, pp. 2035-2046 Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) Agência para a Sociedade do Conhecimento (UMIC)-FCT-Sociedade da Informação instacron:RCAAP |
| ISSN: | 1936-8798 |
| DOI: | 10.1016/j.jcin.2019.06.035 |
| Popis: | Item does not contain fulltext OBJECTIVES: This study sought to evaluate sex differences in procedural characteristics and clinical outcomes of instantaneous wave-free ratio (iFR)- and fractional flow reserve (FFR)-guided revascularization strategies. BACKGROUND: An iFR-guided strategy has shown a lower revascularization rate than an FFR-guided strategy, without differences in clinical outcomes. METHODS: This is a post hoc analysis of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate stenosis to guide Revascularization) study, in which 601 women and 1,891 men were randomized to iFR- or FFR-guided strategy. The primary endpoint was 1-year major adverse cardiac events (MACE), a composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization. RESULTS: Among the entire population, women had a lower number of functionally significant lesions per patient (0.31 +/- 0.51 vs. 0.43 +/- 0.59; p < 0.001) and less frequently underwent revascularization than men (42.1% vs. 53.1%; p < 0.001). There was no difference in mean iFR value according to sex (0.91 +/- 0.09 vs. 0.91 +/- 0.10; p = 0.442). However, the mean FFR value was lower in men than in women (0.83 +/- 0.09 vs. 0.85 +/- 0.10; p = 0.001). In men, an FFR-guided strategy was associated with a higher rate of revascularization than an iFR-guided strategy (57.1% vs. 49.3%; p = 0.001), but this difference was not observed in women (41.4% vs. 42.6%; p = 0.757). There was no difference in MACE rates between iFR- and FFR-guided strategies in both women (5.4% vs. 5.6%, adjusted hazard ratio: 1.10; 95% confidence interval: 0.50 to 2.43; p = 0.805) and men (6.6% vs. 7.0%, adjusted hazard ratio: 0.98; 95% confidence interval: 0.66 to 1.46; p = 0.919). CONCLUSIONS: An FFR-guided strategy was associated with a higher rate of revascularization than iFR-guided strategy in men, but not in women. However, iFR- and FFR-guided strategies showed comparable clinical outcomes, regardless of sex. (Functional Lesion Assessment of Intermediate Stenosis to guide Revascularization [DEFINE-FLAIR]; NCT02053038). |
| Databáze: | OpenAIRE |
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