Sex Differences in the Non-infarct-Related Artery-Based Quantitative Flow Ratio in Patients With ST-Elevation Myocardial Infarction: A Retrospective Study.
Sex Differences in the Non-infarct-Related Artery-Based Quantitative Flow Ratio in Patients With ST-Elevation Myocardial Infarction: A Retrospective Study.
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ST 段抬高型心肌梗死患者非梗死相关动脉定量血流比率的性别差异：一项回顾性研究
DOI：
10.3389/fcvm.2021.726307
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发表时间：
2021
影响因子：
3.6
通讯作者：
Yu B
中科院分区：
文献类型：
--
作者：
Hou H;Zhao Q;Qu C;Sun M;Liu Q;Huang X;Wang X;Zhang R;Du L;Hou J;Yu B
简介：已有研究表明，性别与冠状动脉疾病（CAD）的患病率和主要心血管不良事件的发生率存在明显的相关性。与男性相比，女性冠状动脉和心肌特性的差异影响解剖和功能评价。定量血流比（QFR）已被证明是有效的评估血流动力学相关的病变在稳定性冠状动脉疾病。然而，其在急性心肌梗死患者中的适用性尚不清楚。本研究旨在评价ST段抬高型心肌梗死（STEMI）患者基于非梗死相关动脉（NIRA）的QFR的性别差异。方法：本研究纳入了353例接受血管造影cQFR评估和介入治疗的STEMI患者。根据造影剂流量QFR（cQFR）标准操作规程：使用可靠的软件对无血管诱发充血情况下冠状动脉造影得出的充血流速进行建模。353例患者按性别分为两组。cQFR ≤0.80被认为具有血流动力学显著性，而有创冠状动脉造影（伊卡）管腔狭窄≥50%被认为是阻塞性的。记录人口统计学、临床数据、NIRA相关解剖结构和功能性cQFR值。临床结局包括根据伊卡和cQFR评估的男性和女性之间的NIRA重新分类率。结果：女性年龄较大，体重指数（BMI）高于男性。女性组的舒张压、肌钙蛋白I、肌酸激酶-MB峰值、低密度脂蛋白胆固醇、N末端B型利钠肽前体、支架直径和当前吸烟率显著低于男性组。对于相同程度的狭窄和较低的NIRA血运重建率，女性的阳性cQFR ≤0.80的可能性较低。阳性cQFR的独立预测因素包括男性和直径狭窄（DS）> 70%。结论：cQFR值在性别之间存在差异，因为对于相同程度的狭窄，女性的cQFR值更高。研究结果表明，性别的QFR变化需要具体的解释，因为这些差异可能会影响治疗决策和临床结果。
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.
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影响因子：
158.5
作者：
Wald, David S.;Morris, Joan K.;Oldroyd, Keith G.
通讯作者：
Oldroyd, Keith G.
影响因子：
11.3
作者：
Tu, Shengxian;Barbato, Emanuele;Reiber, Johan H. C.
通讯作者：
Reiber, Johan H. C.
DOI：
10.1016/0735-1097(93)90302-h
发表时间：
1993-05-01
影响因子：
24
作者：
MAUTNER, SL;LIN, FG;ROBERTS, WC
通讯作者：
ROBERTS, WC
影响因子：
37.8
作者：
Mieres, Jennifer H.;Gulati, Martha;Shaw, Leslee J.
通讯作者：
Shaw, Leslee J.
影响因子：
11.3
作者：
Kim, Hyun-Sook;Tonino, Pim A. L.;Fearon, William F.
通讯作者：
Fearon, William F.