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Sex differences in assessing stenosis severity between physician visual assessment and quantitative coronary angiography
- Source :
- International Journal of Cardiology. 348:9-14
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Background Physician visual assessment (PVA) in invasive coronary angiography (ICA) is the current clinical method to determine stenosis severity and guide percutaneous coronary intervention. This study sought to evaluate the effect of sex differences in assessing coronary stenosis severity between PVA and quantitative coronary angiography (QCA). Methods 209 patients with coronary artery disease (288 coronary lesions) underwent ICA and fractional flow reserve (FFR). ICA image processing including PVA and QCA was used to quantify diameter stenosis (DS). The difference of DS (ΔDS) between PVA and QCA was defined as DSPVA-DSQCA. DS ≥50% was considered anatomically obstructive. FFR ≤0.8 was defined as myocardial ischemia. Results Mean ± SD age was 63 ± 9 years. There were no significant differences in DSPVA (61.1 ± 16.3% vs 60.1 ± 18.9%) and DSQCA (53.1 ± 12.1% vs 55.4 ± 14.3%) between females and males. However, ΔDS between PVA and QCA was higher in females (8.0 ± 10.9%) than in males (4.7 ± 10.9%) (P = 0.03). Thirty-four of 72 vessels (47.2%) in female patients and 75 of 216 vessels (34.7%) in male patients were classified differently by at least one grade using PVA compared to QCA assessment. DSPVA and DSQCA were negatively correlated with FFR in females (rPVA = −0.397, rQCA = −0.448) with an even stronger negative correlation in males (rPVA = −0.607, rQCA = −0.607). ROC analysis demonstrated that DSQCA myocardial ischemia (FFR ≤ 0.80) discrimination capability was superior to DSPVA in both sexes (P Conclusions A systematic bias was found in PVA (QCA reference) for overestimating severity of coronary artery disease in females compared to males.
- Subjects :
- Male
Coronary angiography
medicine.medical_specialty
Myocardial ischemia
medicine.medical_treatment
Constriction, Pathologic
Fractional flow reserve
Coronary Angiography
Severity of Illness Index
Coronary artery disease
Predictive Value of Tests
Physicians
Internal medicine
Visual assessment
medicine
Humans
Aged
Sex Characteristics
business.industry
Coronary Stenosis
Percutaneous coronary intervention
Middle Aged
medicine.disease
Coronary Vessels
Fractional Flow Reserve, Myocardial
Stenosis
Diameter stenosis
Cardiology
Female
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 01675273
- Volume :
- 348
- Database :
- OpenAIRE
- Journal :
- International Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....f01c558e27ac15d72c9c7ba7a01ab5cd