Sex Differences in the Non-infarct-Related Artery-Based Quantitative Flow Ratio in Patients With ST-Elevation Myocardial Infarction: A Retrospective Study
Introduction: It has been reported that sex has well-established relationships with the prevalence of coronary artery disease (CAD) and the major adverse cardiovascular events. Compared with men, the difference of coronary artery and myocardial characteristics in women has effects on anatomical and...
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| Format: | Article |
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Frontiers Media S.A.
2021-09-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2021.726307/full |
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| author | Hongli Hou Hongli Hou Qi Zhao Chao Qu Meng Sun Qi Liu Xingtao Huang Xuedong Wang Ruoxi Zhang Lifeng Du Jingbo Hou Bo Yu |
| author_facet | Hongli Hou Hongli Hou Qi Zhao Chao Qu Meng Sun Qi Liu Xingtao Huang Xuedong Wang Ruoxi Zhang Lifeng Du Jingbo Hou Bo Yu |
| author_sort | Hongli Hou |
| collection | DOAJ |
| description | Introduction: It has been reported that sex has well-established relationships with the prevalence of coronary artery disease (CAD) and the major adverse cardiovascular events. Compared with men, the difference of coronary artery and myocardial characteristics in women has effects on anatomical and functional evaluations. Quantitative flow ratio (QFR) has been shown to be effective in assessing the hemodynamic relevance of lesions in stable coronary disease. However, its suitability in acute myocardial infarction patients is unknown. This study aimed to evaluate the sex differences in the non-infarct-related artery (NIRA)-based QFR in patients with ST-elevation myocardial infarction (STEMI).Methods: In this study, 353 patients with STEMI who underwent angiographic cQFR assessment and interventional therapy were included. According to contrast-flow QFR (cQFR) standard operating procedures: reliable software was used to modeling the hyperemic flow velocity derived from coronary angiography in the absence of pharmacologically induced hyperemia. 353 patients were divided into two groups according to sex. A cQFR ≤0.80 was considered hemodynamically significant, whereas invasive coronary angiography (ICA) luminal stenosis ≥50% was considered obstructive. Demographics, clinical data, NIRA-related anatomy, and functional cQFR values were recorded. Clinical outcomes included the NIRA reclassification rate between men and women, according to the ICA and cQFR assessments.Results: Women were older and had a higher body mass index (BMI) than men. The levels of diastolic blood pressure, troponin I, peak creatine kinase-MB, low-density lipoprotein cholesterol, N terminal pro B-type natriuretic peptide, stent diameter, and current smoking rate were found to be significantly lower in the female group than in the male group. Women had a lower likelihood of a positive cQFR ≤0.80 for the same degree of stenosis and a lower rate of NIRA revascularization. Independent predictors of positive cQFR included male sex and diameter stenosis (DS) >70%.Conclusions: cQFR values differ between the sexes, as women have a higher cQFR value for the same degree of stenosis. The findings suggest that QFR variations by sex require specific interpretation, as these differences may affect therapeutic decision-making and clinical outcomes. |
| first_indexed | 2024-12-19T22:12:29Z |
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| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-12-19T22:12:29Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-2e346d6115924feda9085b67ffce75602022-12-21T20:03:51ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2021-09-01810.3389/fcvm.2021.726307726307Sex Differences in the Non-infarct-Related Artery-Based Quantitative Flow Ratio in Patients With ST-Elevation Myocardial Infarction: A Retrospective StudyHongli Hou0Hongli Hou1Qi Zhao2Chao Qu3Meng Sun4Qi Liu5Xingtao Huang6Xuedong Wang7Ruoxi Zhang8Lifeng Du9Jingbo Hou10Bo Yu11Department of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Cardiology, Chenjiaqiao Hospital of Chongqing Medical and Pharmaceutical College, Chongqing, ChinaDepartment of Cardiology, The 1st Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Cardiology, Heilongjiang Provincial People's Hospital, Harbin, ChinaThe Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, Harbin, ChinaDepartment of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Cardiology, Hegang People's Hospital, Hegang, ChinaDepartment of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, ChinaDepartment of Cardiology, The 2nd Affiliated Hospital of Harbin Medical University, Harbin, ChinaIntroduction: It has been reported that sex has well-established relationships with the prevalence of coronary artery disease (CAD) and the major adverse cardiovascular events. Compared with men, the difference of coronary artery and myocardial characteristics in women has effects on anatomical and functional evaluations. Quantitative flow ratio (QFR) has been shown to be effective in assessing the hemodynamic relevance of lesions in stable coronary disease. However, its suitability in acute myocardial infarction patients is unknown. This study aimed to evaluate the sex differences in the non-infarct-related artery (NIRA)-based QFR in patients with ST-elevation myocardial infarction (STEMI).Methods: In this study, 353 patients with STEMI who underwent angiographic cQFR assessment and interventional therapy were included. According to contrast-flow QFR (cQFR) standard operating procedures: reliable software was used to modeling the hyperemic flow velocity derived from coronary angiography in the absence of pharmacologically induced hyperemia. 353 patients were divided into two groups according to sex. A cQFR ≤0.80 was considered hemodynamically significant, whereas invasive coronary angiography (ICA) luminal stenosis ≥50% was considered obstructive. Demographics, clinical data, NIRA-related anatomy, and functional cQFR values were recorded. Clinical outcomes included the NIRA reclassification rate between men and women, according to the ICA and cQFR assessments.Results: Women were older and had a higher body mass index (BMI) than men. The levels of diastolic blood pressure, troponin I, peak creatine kinase-MB, low-density lipoprotein cholesterol, N terminal pro B-type natriuretic peptide, stent diameter, and current smoking rate were found to be significantly lower in the female group than in the male group. Women had a lower likelihood of a positive cQFR ≤0.80 for the same degree of stenosis and a lower rate of NIRA revascularization. Independent predictors of positive cQFR included male sex and diameter stenosis (DS) >70%.Conclusions: cQFR values differ between the sexes, as women have a higher cQFR value for the same degree of stenosis. The findings suggest that QFR variations by sex require specific interpretation, as these differences may affect therapeutic decision-making and clinical outcomes.https://www.frontiersin.org/articles/10.3389/fcvm.2021.726307/fullgender differencesnon-infarct-related arteryST-elevation myocardial infarctionquantitative flow ratiorevascularization |
| spellingShingle | Hongli Hou Hongli Hou Qi Zhao Chao Qu Meng Sun Qi Liu Xingtao Huang Xuedong Wang Ruoxi Zhang Lifeng Du Jingbo Hou Bo Yu Sex Differences in the Non-infarct-Related Artery-Based Quantitative Flow Ratio in Patients With ST-Elevation Myocardial Infarction: A Retrospective Study Frontiers in Cardiovascular Medicine gender differences non-infarct-related artery ST-elevation myocardial infarction quantitative flow ratio revascularization |
| title | Sex Differences in the Non-infarct-Related Artery-Based Quantitative Flow Ratio in Patients With ST-Elevation Myocardial Infarction: A Retrospective Study |
| title_full | Sex Differences in the Non-infarct-Related Artery-Based Quantitative Flow Ratio in Patients With ST-Elevation Myocardial Infarction: A Retrospective Study |
| title_fullStr | Sex Differences in the Non-infarct-Related Artery-Based Quantitative Flow Ratio in Patients With ST-Elevation Myocardial Infarction: A Retrospective Study |
| title_full_unstemmed | Sex Differences in the Non-infarct-Related Artery-Based Quantitative Flow Ratio in Patients With ST-Elevation Myocardial Infarction: A Retrospective Study |
| title_short | Sex Differences in the Non-infarct-Related Artery-Based Quantitative Flow Ratio in Patients With ST-Elevation Myocardial Infarction: A Retrospective Study |
| title_sort | sex differences in the non infarct related artery based quantitative flow ratio in patients with st elevation myocardial infarction a retrospective study |
| topic | gender differences non-infarct-related artery ST-elevation myocardial infarction quantitative flow ratio revascularization |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2021.726307/full |
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