Effect of Sex Difference on Discordance Between Instantaneous Wave-Free Ratio and Fractional Flow Reserve

Shunsuke Aoi, Bora Toklu, Naoki Misumida, Neil Patel, Wonkyoung Lee, John Fox, Hitoshi Matsuo, Yumiko Kanei

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Background: Physiology-guided percutaneous coronary intervention (PCI) has demonstrated to improve clinical outcomes. Previous trials showed the agreement between iFR and FFR is approximately 80%, however the details of discordance pattern remain to be elucidated. Methods: We retrospectively reviewed 1024 consecutive intermediate stenotic lesions for which functional evaluation using both iFR and FFR were performed between January 2015 and June 2016. The lesions were classified into 4 groups according to iFR and FFR concordance [(iFR+/FFR+) and (iFR-/FFR-)] or discordance [(iFR+/FFR-) and (iFR-/FFR+)]. Results: Our study evaluated 451 lesions, 264 lesions (58.5%) from men and 187 lesions (41.5%) from women. iFR was similar between women and men, however FFR was significantly higher in women than men. The rate of discordance between iFR and FFR was 21.3% (iFR+/FFR- 12.4% and iFR-/FFR+ 8.9%) in overall cohort. The prevalence of overall concordance and discordance were similar between men and women, however iFR+/FFR- discordance was significantly higher in women (17.1% vs. 9.1%) whereas iFR-/FFR+ discordance was significantly higher in men (11.3% vs. 4.8%). In multivariable analysis, female sex and older age were significantly associated with iFR+/FFR- discordance (odds ratio 1.88 and 1.48, respectively). Conversely, younger age, higher stenosis, and concomitant chronic total occlusion were independent predictors for iFR-/FFR+ discordance (odds ratio 0.67, 1.82, and 4.32, respectively). Conclusions: Despite similar prevalence of overall concordance and discordance between men and women, iFR+/FFR- discordance was higher in women and iFR-/FFR+ discordance was higher in men. Multivariable analysis showed female sex to be independent predictor of iFR+/FFR- discordance.

Original languageEnglish
Pages (from-to)57-64
Number of pages8
JournalCardiovascular Revascularization Medicine
Volume24
DOIs
StatePublished - Mar 2021
Externally publishedYes

Keywords

  • Coronary artery disease
  • Fractional flow reserve
  • Instantaneous wave-free ratio
  • Sex difference

Fingerprint

Dive into the research topics of 'Effect of Sex Difference on Discordance Between Instantaneous Wave-Free Ratio and Fractional Flow Reserve'. Together they form a unique fingerprint.

Cite this