Abstract 18406: Gender Influence on the Functional Significance of Intermediate Coronary Artery Stenosis

Abstract

Background Previous studies suggest that there are clinically relevant differences between women and men in patients with ischemic heart disease. However, little is known about the gender influence on the functional significance of coronary artery stenosis. Method A total of 1,032 lesions with available intravascular ultrasound (IVUS) and fractional flow reserve (FFR) were recruited from 11 international centers and 881 de novo lesions with intermediate stenosis located at the non-left main major epicardial coronary arteries (822 patients, male 70.6%) were included in this analysis. All data were analyzed at Seoul National University Data Management Core Laboratory. FFR ≤0.8 was considered functionally significant. Results Angiographic % diameter stenosis and reference diameter were 49.6±12.7 and 3.0±0.5 mm, respectively. Minimum luminal area (MLA) by IVUS was 3.12±1.34mm 2 . Mean FFR was 0.81±0.11 and 353 lesions (40.1%) were functionally significant. There were no differences in angiographic lesion severity and IVUS MLA between male and female patients (Table). However, compared to female patients, FFR was significantly lower in male (male: 0.81±0.11 vs. female: 0.83±0.10, P =0.010) and functionally significant stenosis was more frequent in male patients (FFR ≤0.8; male: 42.8% vs. female: 32.9%, P =0.007). The best cutoff value of angiographic % diameter stenosis to determine the functional significance was 49.4% in male and 53.0% in female patients. The best cutoff value of IVUS MLA was 3.25 mm 2 in male and 3.05 mm 2 in female patients. Conclusion Compared to male patients, female patients may have higher anatomical threshold for the functional significance of coronary artery stenosis.