関連する実験動画

Updated: Jan 8, 2026

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration

Published on: April 4, 2022

経皮的冠動脈形成術後の残存狭心症における性別の影響

Masahiro Hada^1,2, Takuya Mizukami^1,3, Kazumasa Ikeda^1,4

¹Cardiovascular Center Aalst, AZORG, Aalst, Belgium.

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions

|December 18, 2025

要旨

Background:

Sex-related differences in the clinical presentation of coronary artery disease (CAD) are well recognized. The pullback pressure gradient (PPG) characterizes pathophysiological CAD patterns as focal or diffuse.

Objectives:

To evaluate the influence of sex on residual angina at one year after percutaneous coronary intervention (PCI), stratified by PPG.

Methods:

We performed a sub-analysis of PPG Global, a multicenter, prospective, single-arm study. All patients had hemodynamically significant CAD (fractional flow reserve [FFR] ≤ 0.80) and underwent a manual FFR pullbacks to calculate PPG before PCI. Patient-reported outcomes were collected using the 7-item Seattle Angina Questionnaire (SAQ-7) at baseline and 1-year follow-up.

Results:

We included 814 patients (205 [25.2%] women and 609 [74.8%] men). Women were significantly older than men (70 ± 10 years vs. 67 ± 10 years p < 0.001). Baseline FFR were comparable between sexes (0.68 ± 0.13 vs. 0.66 ± 0.12, p = 0.098), but women had a more focal CAD compared to men (PPG 0.66 ± 0.15 vs. 0.63 ± 0.15, p = 0.047). Post PCI-FFR was higher in women than men (0.88 ± 0.07 vs. 0.87 ± 0.07, p = 0.041); however, angina at 1 year was more frequent in women (SAQ angina frequency score 94 ± 12 vs. 96 ± 10, p = 0.041).

Conclusion:

Despite having a more focal CAD pattern and achieving higher post-PCI FFR, women report more residual angina than men at 1-year follow-up.

Trial Registration:

ClinicalTrials.gov NCT04789317.

キーワード:

冠動脈疾患病態生理学的パターンプルバック圧勾配残存狭心症性差

さらに関連する動画

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders

Published on: August 18, 2016

関連する概念動画

Angina IV: Management

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...

Angina II: Classification

Angina II: Classification

Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...

Angina I: Introduction

Angina I: Introduction

Definition and Symptoms: Angina (angina pectoris) is chest pain or discomfort caused by myocardial ischemia, which occurs when the heart muscle receives insufficient oxygen-rich blood. It typically manifests as pressing, squeezing, or crushing sensations in the chest and may radiate to the shoulders, arms, neck, jaw, or back.Primary Cause: In a healthy state, the coronary arteries can dilate (widen) to increase blood flow and meet the increased oxygen demand during physical activity or...

Angina III: Clinical Manifestations and Assessment

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...

Angina V: Nursing Management

Angina V: Nursing Management

Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...

Acute Coronary Syndrome IV: Interprofessional Care

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...