Key result
Women undergoing fractional flow reserve assessment had significantly lower overall in-hospital revascularization rates compared to men (40.1% vs. 52.8%, p < 0.01).
Why the study?
Are there sex differences in coronary revascularization rates and in-hospital outcomes following fractional flow reserve (FFR) assessment?
Observational (n=3,712)
Yes
Are there sex differences in coronary revascularization rates and in-hospital outcomes following fractional flow reserve (FFR) assessment?
Absolute Event Rate: 40.1% vs 52.8%
p-value: p=<0.01
Women undergo significantly less coronary revascularization than men even when functional assessment with FFR is utilized, highlighting persistent sex disparities in CAD management.
Persistent sex differences in revascularization after FFR warrant investigation; leaves open whether this reflects bias or appropriate care.
BACKGROUND: Women with coronary artery disease are less likely to be revascularized than men based on angiography alone. Recent studies have shown that female patients have higher fractional flow reserve (FFR) values for a given severity of coronary stenosis. However, gender differences in coronary revascularization rates following FFR assessment are unknown. METHODS: The nationwide inpatient sample database was used to identify all patients who underwent FFR in the United States between January 2009 and December 2010. We used propensity score matching to compare revascularization rates and in-hospital outcomes among men and women undergoing FFR measurements. RESULTS: Among 3712 patients who underwent FFR during the study period, 1235 matched pairs of men and women were identified. The overall revascularization rates were lower in women than men (40.1% vs. 52.8%, p < 0.01). Women were less likely to undergo either percutaneous (35.2% vs. 45.6%, p < 0.01) or surgical revascularization following FFR than men (5.2% vs. 7.4%, p = 0.03). Women had a nonsignificant trend toward higher in-hospital mortality (0.8% vs. 0.5%, p = 0.32) and significantly higher rates of access site hematoma formation (2.7% vs. 0.8%, p < 0.01) compared to men. CONCLUSION: In conclusion, this large nationwide study reveals that coronary revascularization rates are significantly lower in women than in men even after functional assessment with FFR.
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Lakhter et al. (2016) conducted an observational in Coronary artery disease (n=3,712). Female sex vs. Male sex was evaluated on Overall revascularization rates (p=<0.01). Women undergoing fractional flow reserve assessment had significantly lower overall in-hospital revascularization rates compared to men (40.1% vs. 52.8%, p < 0.01).
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