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Influence of Sex on Relationship Between Total Anatomical and Physiologic Disease Burdens and Their Prognostic Implications in Patients With Coronary Artery Disease

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Affiliated Author(s)
남창욱
Alternative Author(s)
Nam, Chang Wook
Journal Title
Journal of the American Heart Association
ISSN
2047-9980
Issued Date
2019
Keyword
coronary artery diseasefractional flow reserveprognosissexSYNTAX scoretotal disease burden
Abstract
Background-
—Total atherosclerosis disease burden is associated with clinical outcomes in patients with coronary artery disease. However, the influence of sex on the relationship between total anatomical and physiologic disease burdens and their prognostic implications have not been well defined.

Methods and Results-
—A total of 1136 patients who underwent fractional flow reserve (FFR) measurement in all 3 major coronary arteries were included in this study. Anatomical and physiologic total disease burden was assessed by SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score, residual SYNTAX score, a total sum of FFR in 3 vessels (3-vessel FFR), and functional SYNTAX score. The primary end point was major adverse cardiac events, a composite of cardiac death, myocardial infarction, and ischemia-driven revascularization at 2 years. There were no differences in angiographic diameter stenosis, SYNTAX score, or residual SYNTAX score between women and men. However, both per-vessel FFR (0.89 0.10 versus 0.87 0.11, P<0.001) and 3-vessel FFR (2.72 0.13 versus 2.69 0.15, P<0.001) were higher in women. Multivariable Cox regression analyses showed that total anatomical and physiologic disease burdens were significantly associated with 2-year major adverse cardiac events, and there was no significant interaction between sex and total disease burden for clinical outcomes.

Conclusions-
—Despite similar angiographic disease severity, both per-vessel and per-patient physiologic disease severity was less in women than in men. There was no influence of sex on prognostic implications of total anatomical and physiologic disease burdens in patients with coronary artery disease.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine (의과대학)
Citation
You-Jung Choi et al. (2019). Influence of Sex on Relationship Between Total Anatomical and Physiologic Disease Burdens and Their Prognostic Implications in Patients With Coronary Artery Disease. Journal of the American Heart Association, 8(5), e011002–e011002. doi: 10.1161/JAHA.118.011002
Type
Article
ISSN
2047-9980
DOI
10.1161/JAHA.118.011002
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41943
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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