Sex differences in fractional flow reserve-guided revascularization: A nationwide analysis

Vladimir Lakhter, Mohamad Alkhouli, Chad Zack, Huaqing Zhao, Howard A. Cohen, Brian P. O'Neill, Brian O'Murchu, Alfred A. Bove, Riyaz Bashir

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)109-115
Number of pages7
JournalJournal of Women's Health
Volume26
Issue number2
DOIs
StatePublished - Feb 1 2017

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Sex Characteristics
Propensity Score
Coronary Stenosis
Hospital Mortality
Hematoma
Inpatients
Coronary Artery Disease
Angiography
Databases

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Lakhter, V., Alkhouli, M., Zack, C., Zhao, H., Cohen, H. A., O'Neill, B. P., ... Bashir, R. (2017). Sex differences in fractional flow reserve-guided revascularization: A nationwide analysis. Journal of Women's Health, 26(2), 109-115. https://doi.org/10.1089/jwh.2016.5806
Lakhter, Vladimir ; Alkhouli, Mohamad ; Zack, Chad ; Zhao, Huaqing ; Cohen, Howard A. ; O'Neill, Brian P. ; O'Murchu, Brian ; Bove, Alfred A. ; Bashir, Riyaz. / Sex differences in fractional flow reserve-guided revascularization : A nationwide analysis. In: Journal of Women's Health. 2017 ; Vol. 26, No. 2. pp. 109-115.
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abstract = "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, V, Alkhouli, M, Zack, C, Zhao, H, Cohen, HA, O'Neill, BP, O'Murchu, B, Bove, AA & Bashir, R 2017, 'Sex differences in fractional flow reserve-guided revascularization: A nationwide analysis', Journal of Women's Health, vol. 26, no. 2, pp. 109-115. https://doi.org/10.1089/jwh.2016.5806

Sex differences in fractional flow reserve-guided revascularization : A nationwide analysis. / Lakhter, Vladimir; Alkhouli, Mohamad; Zack, Chad; Zhao, Huaqing; Cohen, Howard A.; O'Neill, Brian P.; O'Murchu, Brian; Bove, Alfred A.; Bashir, Riyaz.

In: Journal of Women's Health, Vol. 26, No. 2, 01.02.2017, p. 109-115.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Sex differences in fractional flow reserve-guided revascularization

T2 - A nationwide analysis

AU - Lakhter, Vladimir

AU - Alkhouli, Mohamad

AU - Zack, Chad

AU - Zhao, Huaqing

AU - Cohen, Howard A.

AU - O'Neill, Brian P.

AU - O'Murchu, Brian

AU - Bove, Alfred A.

AU - Bashir, Riyaz

PY - 2017/2/1

Y1 - 2017/2/1

N2 - 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.

AB - 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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