Bujak Marta, Malinowski Krzysztof, Siudak Zbigniew, Ćmiel Anna, Lesiak Maciej, Bartuś Stanisław, Legutko Jacek, Wańha Wojciech, Witkowski Adam, Dudek Dariusz, Gąsior Mariusz, Gil Robert, Protasiewicz Marcin, Kubica Jacek, Godek Piotr, Wojakowski Wojciech, Gąsior Paweł
Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, 40-055 Katowice, Poland.
Department of Bioinformatics and Telemedicine, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Krakow, Poland.
J Clin Med. 2024 Jul 10;13(14):4028. doi: 10.3390/jcm13144028.
: The literature review shows that female patients are more frequently underdiagnosed or suffer from delayed diagnosis. Recognition of sex-related differences is crucial for implementing strategies to improve cardiovascular outcomes. We aimed to assess sex-related disparities in the frequency of fractional flow reserve (FFR)-guided procedures in patients who underwent angiography and/or percutaneous coronary intervention (PCI). : We have derived the data from the national registry of percutaneous coronary interventions and retrospectively analyzed the data of more than 1.4 million angiography and/or PCI procedures [1,454,121 patients (62.54% men and 37.46% women)] between 2014 and 2022. The logistic regression analysis was conducted to explore whether female sex was associated with FFR utilization. : The FFR was performed in 61,305 (4.22%) patients and more frequently in men than women (4.15% vs. 3.45%, < 0.001). FFR was more frequently assessed in females with acute coronary syndrome than males (27.75% vs. 26.08%, < 0.001); however, women with chronic coronary syndrome had FFR performed less often than men (72.25% vs. 73.92%, < 0.001). Females with FFR-guided procedures were older than men (69.07 (±8.87) vs. 65.45 (±9.38) < 0.001); however. less often had a history of myocardial infarction (MI) (24.79% vs. 36.73%, < 0.001), CABG (1.62% vs. 2.55%, < 0.005) or PCI (36.6% vs. 24.79%, < 0.001) compared to men. Crude comparison has shown that male sex was associated with a higher frequency of FFR assessment (OR = 1.2152-1.2361, < 0.005). : Despite a substantial rise in FFR utilization, adoption in women remains lower than in men. Female sex was found to be an independent negative predictor of FFR use.
文献综述表明，女性患者更常被漏诊或诊断延迟。认识到性别差异对于实施改善心血管疾病预后的策略至关重要。我们旨在评估接受血管造影和/或经皮冠状动脉介入治疗（PCI）的患者中，血流储备分数（FFR）引导下手术频率的性别差异。
我们从国家经皮冠状动脉介入治疗登记处获取数据，并回顾性分析了2014年至2022年间超过140万例血管造影和/或PCI手术的数据[1,454,121例患者（男性占62.54%，女性占37.46%）]。进行逻辑回归分析以探讨女性性别是否与FFR的使用相关。
共有61,305例（4.22%）患者进行了FFR检查，男性的检查频率高于女性（4.15%对3.45%，P<0.001）。急性冠状动脉综合征女性患者接受FFR评估的频率高于男性（27.75%对26.08%，P<0.001）；然而，慢性冠状动脉综合征女性患者进行FFR检查的频率低于男性（72.25%对73.92%，P<0.001）。接受FFR引导下手术的女性患者年龄大于男性（69.07（±8.87）岁对65.45（±9.38）岁，P<0.001）；然而，与男性相比，她们既往心肌梗死（MI）病史（24.79%对36.73%，P<0.001）、冠状动脉旁路移植术（CABG）病史（1.62%对2.55%，P<0.005）或PCI病史（36.6%对24.79%，P<0.001）的发生率更低。粗略比较显示，男性性别与更高的FFR评估频率相关（OR = 1.2152 - 1.2361，P<0.005）。
尽管FFR的使用有显著增加，但女性中的应用率仍低于男性。女性性别被发现是FFR使用的独立负性预测因素。
