Does sex impact pathophysiological CAD patterns (focal versus diffuse) and physiological outcomes in stable patients undergoing PCI?
Women with stable CAD undergoing PCI exhibit more focal disease distribution, higher angina burden, and better post-PCI physiological results compared to men.
BACKGROUND: Sex differences in coronary artery disease (CAD) have been increasingly recognized, as women present with distinct clinical characteristics and outcomes compared with men. This study investigated the impact of sex on pathophysiological CAD patterns (focal versus diffuse) in stable patients undergoing percutaneous coronary interventions (PCI). METHODS: We conducted a subanalysis of the PPG Global (Pullback Pressure Gradient Global Registry) study, a multicenter, prospective trial including 993 patients (236 23.8% women and 757 76.2% men) with hemodynamically significant CAD, defined as fractional flow reserve ≤0.80. The pullback pressure gradient metric categorized CAD patterns as focal or diffuse. Patient-reported outcomes were collected using the 7-item Seattle Angina Questionnaire. Optimal revascularization was defined as post-PCI fractional flow reserve ≥0.88. RESULTS: =0.01). CONCLUSIONS: This study reveals clinically significant differences in CAD patterns between sexes, with women demonstrating a higher burden of angina, more focal disease distribution, and better physiological results after PCI.
Ikeda et al. (Mon,) studied this question.