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Sex Differences in Fractional Flow Reserve-Guided Revascularization: A Nationwide Analysis.

Vladimir Lakhter1, Mohamad Alkhouli2, Chad J Zack3

  • 11 Division of Cardiovascular Diseases, Department of Medicine, Temple University Hospital , Philadelphia, Pennsylvania.

Journal of Women'S Health (2002)
|October 19, 2016
PubMed
Summary

Women with coronary artery disease receive fewer revascularization procedures than men, even after fractional flow reserve (FFR) assessment. This large study highlights a persistent gender gap in treating coronary artery disease.

Keywords:
CABGfractional flow reservegenderpercutaneous revascularization

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Health Services Research

Background:

  • Coronary artery disease (CAD) management disparities exist, with women historically less likely to undergo revascularization compared to men.
  • While angiography alone may underestimate stenosis severity in women, recent data suggest higher fractional flow reserve (FFR) values in female patients.
  • Gender-based differences in revascularization rates following FFR assessment in CAD patients remain largely unexplored.

Purpose of the Study:

  • To investigate gender-based disparities in coronary revascularization rates after FFR assessment.
  • To compare in-hospital outcomes between men and women undergoing FFR measurements for CAD.

Main Methods:

  • Utilized the Nationwide Inpatient Sample database (2009-2010) to identify patients who underwent FFR.
  • Employed propensity score matching to create comparable cohorts of men and women.
  • Analyzed revascularization rates (percutaneous and surgical) and in-hospital outcomes.

Main Results:

  • A total of 1235 matched pairs of men and women undergoing FFR were analyzed.
  • Overall revascularization rates were significantly lower in women (40.1%) compared to men (52.8%).
  • Women were less likely to undergo both percutaneous (35.2% vs. 45.6%) and surgical revascularization (5.2% vs. 7.4%). Women experienced higher rates of access site hematoma (2.7% vs. 0.8%).

Conclusions:

  • Coronary revascularization rates remain significantly lower in women than men, even after functional assessment with FFR.
  • This study underscores a persistent gender disparity in the utilization of revascularization procedures for coronary artery disease.
  • Further research is warranted to understand and address the underlying reasons for these observed gender differences.