Sex Differences in Fractional Flow Reserve Utilization

• Published in: Journal of clinical medicine Vol. 13; no. 14; p. 4028
• Main Authors: Bujak, Marta, Malinowski, Krzysztof, Siudak, Zbigniew, Ćmiel, Anna, Lesiak, Maciej, Bartuś, Stanisław, Legutko, Jacek, Wańha, Wojciech, Witkowski, Adam, Dudek, Dariusz, Gąsior, Mariusz, Gil, Robert, Protasiewicz, Marcin, Kubica, Jacek, Godek, Piotr, Wojakowski, Wojciech, Gąsior, Paweł
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 10.07.2024
• Subjects: Acute coronary syndromes; Females; FFR; Gender differences; Medical imaging; PCI; physiological assessment; sex; Poland; physiological assessment; FFR; PCI; sex
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm13144028

: The literature review shows that female patients are more frequently underdiagnosed or suffer from delayed diagnosis. Recognition of sex-related differences is crucial for implementing strategies to improve cardiovascular outcomes. We aimed to assess sex-related disparities in the frequency of fractional flow reserve (FFR)-guided procedures in patients who underwent angiography and/or percutaneous coronary intervention (PCI). : We have derived the data from the national registry of percutaneous coronary interventions and retrospectively analyzed the data of more than 1.4 million angiography and/or PCI procedures [1,454,121 patients (62.54% men and 37.46% women)] between 2014 and 2022. The logistic regression analysis was conducted to explore whether female sex was associated with FFR utilization. : The FFR was performed in 61,305 (4.22%) patients and more frequently in men than women (4.15% vs. 3.45%, < 0.001). FFR was more frequently assessed in females with acute coronary syndrome than males (27.75% vs. 26.08%, < 0.001); however, women with chronic coronary syndrome had FFR performed less often than men (72.25% vs. 73.92%, < 0.001). Females with FFR-guided procedures were older than men (69.07 (±8.87) vs. 65.45 (±9.38) < 0.001); however. less often had a history of myocardial infarction (MI) (24.79% vs. 36.73%, < 0.001), CABG (1.62% vs. 2.55%, < 0.005) or PCI (36.6% vs. 24.79%, < 0.001) compared to men. Crude comparison has shown that male sex was associated with a higher frequency of FFR assessment (OR = 1.2152-1.2361, < 0.005). : Despite a substantial rise in FFR utilization, adoption in women remains lower than in men. Female sex was found to be an independent negative predictor of FFR use.