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Sex Differences in Clinical Outcomes Associated With Quantitative Flow Ratio-Guided Percutaneous

Yundai Chen1, Lei Gao2, Birgit Vogel3

  • 1Department of Cardiology, the First Medical Center of Chinese PLA General Hospital, Beijing, China.

JACC. Asia
|March 11, 2024
PubMed

Insights

Quantitative flow ratio (QFR)-guided percutaneous coronary intervention (PCI) improved outcomes for both men and women with coronary artery disease. QFR guidance demonstrated similar benefits across sexes, reducing major adverse cardiac events compared to standard angiography guidance.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • The FAVOR III China trial showed improved outcomes with quantitative flow ratio (QFR)-guided percutaneous coronary intervention (PCI) over standard angiography guidance.
  • However, the impact of QFR-guided PCI on clinical outcomes, specifically considering sex differences, remained unclear.

Purpose of the Study:

  • To investigate potential sex-based differences in the 2-year clinical benefits of QFR-guided PCI.
  • To compare outcomes between men and women undergoing contemporary PCI strategies.

Main Methods:

  • A subgroup analysis of the FAVOR III China trial was conducted, randomizing participants to either QFR-guided or angiography-guided PCI.
  • Major adverse cardiac events (MACE), including all-cause death, myocardial infarction, or ischemia-driven revascularization, were analyzed over 2 years.
  • Sex differences in the efficacy of QFR guidance were assessed.

Main Results:

  • The study included 1,126 women and 2,699 men, with similar 2-year MACE rates between sexes (10.3% vs 10.5%).
  • QFR-guided PCI reduced PCI rates by 7.9% in men and 9.7% in women compared to angiography guidance.
  • Both women (8.0% vs 12.7%) and men (8.7% vs 12.4%) experienced similar relative risk reductions in MACE with QFR guidance, with no significant interaction by sex (Pinteraction = 0.61).

Conclusions:

  • QFR-guided PCI significantly improved 2-year MACE outcomes in both men and women compared to angiography-guided PCI.
  • The clinical benefits of QFR-guided PCI were consistent across sexes, indicating its broad applicability in patients with coronary artery disease.
Abstract

Keywords:
percutaneous coronary interventionquantitative flow ratiosex difference

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