The role of gender in resting full-cycle ratio (RFR) guided coronary revascularization

Int J Cardiol. 2024 Aug 1:408:132159. doi: 10.1016/j.ijcard.2024.132159. Epub 2024 May 12.

Abstract

Background: Gender-based differences in clinical outcomes of patients undergoing fractional flow reserved (FFR) guided coronary revascularization is well documented. This study aimed to compare resting full-cycle ratio (RFR) values between men and women and whether this translated into difference in clinical outcomes in patients who underwent RFR-guided coronary revascularization.

Methods: This was a retrospective single-centre study of consecutive patients who underwent RFR-guided revascularization for coronary lesions with intermediate degree of stenosis. The primary endpoint was a composite of all-cause mortality, myocardial infarction (MI), unplanned revascularization, and unstable angina requiring hospital admission at one year.

Results: In 373 consecutive patients (510 lesions, 26% women) there was no statistically significant difference in RFR value between men and women (0.90 ± 10 versus 0.90 ± 11, P = 0.95). There was no statistically significant difference between men and women in the primary endpoint, even after adjustment to the imbalance between the two groups [3.7% vs. 3.0%; HR 1.43, 95% CI (0.46 to 4.43), P = 0.54]; or its individual components of death (1.1% vs 0.8%, P = 0.76), MI (1.9% vs 0.8%, P = 0.38) or unplanned revascularization, including unstable angina admissions (2.6% vs 2.3%, P = 0.82). The comparable clinical outcomes were consistent across all different subgroups, including clinical presentation, diabetes status, left ventricle systolic function, kidney function, and the interrogated coronary artery.

Conclusion: Our study suggests no significant gender-based difference in the value of RFR or 1-year clinical outcomes in patients undergoing resting physiology guided coronary revascularization.

Keywords: Clinical outcomes; RFR; Women.

MeSH terms

  • Aged
  • Coronary Angiography
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / physiopathology
  • Coronary Stenosis / surgery
  • Female
  • Follow-Up Studies
  • Fractional Flow Reserve, Myocardial* / physiology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Revascularization / methods
  • Percutaneous Coronary Intervention / methods
  • Retrospective Studies
  • Sex Characteristics
  • Sex Factors
  • Treatment Outcome