Impact of Sex Differences on the Outcomes of Coronary Invasive Physiological Assessment: Long-Term Follow-Up in a Brazilian Population

Abstract

Objective: This study aimed to evaluate the rate of major adverse cardiac events (MACEs; the sum of death, myocardial infarction, and revascularization rates) according to interventional strategies guided by invasive physiological methods in both sexes in a Brazilian population during long-term follow-up for an average of 2 years. Methods: This retrospective single-center study included 151 consecutive patients (232 lesions) between January 2018 and January 2022. The participants were divided into two groups: the female group (FG), comprising 59 patients with 88 lesions, and the male group (MG), comprising 92 patients with 144 lesions. Results: The FG had a greater mean age (FG: 67.96???13.12 vs. MG: 62.36???12.01 years, p?=?0.009) and lower mean creatinine clearance (FG: 79.35???38.63 vs. MG: 92.02???38.62?mL/min, p?=?0.02) than did the MG. The percentage of lesions in the left main coronary artery was higher in the FG than in the MG (12.5% vs. 2.78%, p?=?0.006). The mean follow-up time was longer in the MG than in the FG (795.61???350 vs. 619.19???318 days, respectively; p?=?0.001). MACE occurred in 11.86% and 13.04% of patients in the FG and MG, respectively (p?=?0.850). Secondary outcomes, such as death, reinfarction, and the need for new revascularization, showed no significant between-sex differences. Conclusions: Our study demonstrated the safety of invasive physiological methods to determine coronary revascularization in both male and female patients in a Brazilian population, as evidenced by the low rates of adverse cardiac events and death after a long-term follow-up.

Keywords

• coronary disease
• coronary stent
• fractional flow reserve
• revascularization