Circulation Reports
Online ISSN : 2434-0790

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Sex Differences in 5-Year Outcomes After Deferral of Revascularization Following Physiological Coronary Assessment
Takayuki IshiharaShoichi Kuramitsu Hitoshi MatsuoKazunori HorieHiroaki TakashimaHidenobu TeraiYuetsu KikutaTatsuya SaigusaTomohiro SakamotoNobuhiro SuematsuYasutsugu ShionoTaku AsanoKenichi TsujitaKatsuhiko MasamuraTatsuki DoijiriFumitoshi ToyotaManabu OgitaTairo KuritaAkiko MatsuoKen HaradaKenji YaginumaShinjo SonodaHiroyoshi YokoiNobuhiro TanakaToshiaki Manoon behalf of the J-CONFIRM Investigators
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論文ID: CR-23-0100

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Background: The relationship between sex differences and long-term outcomes after fractional flow reserve (FFR)- and instantaneous wave-free ratio (iFR)-guided deferral of revascularization has yet to be elucidated.

Methods and Results: From the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention based on FFR in a multicenter registry), this study included 432 lesions from 385 patients (men, 323 lesions in 286 patients; women, 109 lesions in 99 patients) with paired data of FFR and iFR. The primary endpoint was the cumulative 5-year incidence of target vessel failure (TVF), including cardiac death, target vessel-related myocardial infarction, and clinically driven target vessel revascularization. The median FFR value was lower in men than in women (0.85 [0.81, 0.88] vs. 0.87 [0.83, 0.91], P=0.002), but the iFR value was comparable between men and women (0.94 [0.90, 0.98] vs. 0.93 [0.89, 0.98], P=0.26). The frequency of discordance between FFR and iFR was comparable between men and women (19.5% vs. 23.9%, P=0.34), although with different discordance patterns (P=0.036). The cumulative incidence of 5-year TVF did not differ between men and women after adjustment for baseline characteristics (13.9% vs. 6.9%, adjusted hazard ratio 1.82 [95% confidence interval: 0.44–7.56]; P=0.41).

Conclusions: Despite sex differences in the results for physiological indexes, the 5-year TVF in deferred lesions did not differ between men and women after adjustment for baseline characteristics.

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