Sex differences in machine learning computed tomography-derived fractional flow reserve
Coronary computed tomography angiography (CCTA) derived machine learning fractional flow reserve (ML-FFR CT ) can assess the hemodynamic significance of coronary artery stenoses. We aimed to assess sex differences in the association of ML-FFR CT and incident cardiovascular outcomes. We studied a ret...
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Published in | Scientific reports Vol. 12; no. 1; p. 13861 |
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Main Authors | , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
London
Nature Publishing Group UK
16.08.2022
Nature Publishing Group Nature Portfolio |
Subjects | |
Online Access | Get full text |
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Summary: | Coronary computed tomography angiography (CCTA) derived machine learning fractional flow reserve (ML-FFR
CT
) can assess the hemodynamic significance of coronary artery stenoses. We aimed to assess sex differences in the association of ML-FFR
CT
and incident cardiovascular outcomes. We studied a retrospective cohort of consecutive patients who underwent clinically indicated CCTA and single photon emission computed tomography (SPECT). Obstructive stenosis was defined as ≥ 70% stenosis severity in non-left main vessels or ≥ 50% in the left main coronary. ML-FFR
CT
was computed using a machine learning algorithm with significant stenosis defined as ML-FFR
CT
< 0.8. The primary outcome was a composite of death or non-fatal myocardial infarction (D/MI). Our study population consisted of 471 patients with mean (SD) age 65 (13) years, 53% men, and multiple comorbidities (78% hypertension, 66% diabetes, 81% dyslipidemia). Compared to men, women were less likely to have obstructive stenosis by CCTA (9% vs. 18%; p = 0.006), less multivessel CAD (4% vs. 6%; p = 0.25), lower prevalence of ML-FFR
CT
< 0.8 (39% vs. 44%; p = 0.23) and higher median (IQR) ML-FFR
CT
(0.76 (0.53–0.86) vs. 0.71 (0.47–0.84); p = 0.047). In multivariable adjusted models, there was no significant association between ML-FFR
CT
< 0.8 and D/MI [Hazard Ratio 0.82, 95% confidence interval (0.30, 2.20); p = 0.25 for interaction with sex.]. In a high-risk cohort of symptomatic patients who underwent CCTA and SPECT testing, ML-FFR
CT
was higher in women than men. There was no significant association between ML-FFR
CT
and incident mortality or MI and no evidence that the prognostic value of ML-FFR
CT
differs by sex. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 2045-2322 2045-2322 |
DOI: | 10.1038/s41598-022-17875-9 |