Background: Sex-related differences in the clinical presentation of coronary artery disease (CAD) are well recognized. The pullback pressure gradient (PPG) characterizes pathophysiological CAD patterns as focal or diffuse. Objectives: To evaluate the influence of sex on residual angina at one year after percutaneous coronary intervention (PCI), stratified by PPG. Methods: We performed a sub-analysis of PPG Global, a multicenter, prospective, single-arm study. All patients had hemodynamically significant CAD (fractional flow reserve [FFR] ≤ 0.80) and underwent a manual FFR pullbacks to calculate PPG before PCI. Patient-reported outcomes were collected using the 7-item Seattle Angina Questionnaire (SAQ-7) at baseline and 1-year follow-up. Results: We included 814 patients (205 [25.2%] women and 609 [74.8%] men). Women were significantly older than men (70 ± 10 years vs. 67 ± 10 years p < 0.001). Baseline FFR were comparable between sexes (0.68 ± 0.13 vs. 0.66 ± 0.12, p = 0.098), but women had a more focal CAD compared to men (PPG 0.66 ± 0.15 vs. 0.63 ± 0.15, p = 0.047). Post PCI-FFR was higher in women than men (0.88 ± 0.07 vs. 0.87 ± 0.07, p = 0.041); however, angina at 1 year was more frequent in women (SAQ angina frequency score 94 ± 12 vs. 96 ± 10, p = 0.041). Conclusion: Despite having a more focal CAD pattern and achieving higher post-PCI FFR, women report more residual angina than men at 1-year follow-up. Trial Registration: ClinicalTrials.gov NCT04789317.
Impact of Sex on Residual Angina After Percutaneous Coronary Interventions / Hada, Masahiro; Mizukami, Takuya; Ikeda, Kazumasa; Munhoz, Daniel; Brouwers, Sofie; Sonck, Jeroen; Matsuo, Hitoshi; Shinke, Toshiro; Ando, Hirohiko; Ko, Brian; Biscaglia, Simone; Rivero, Fernando; Engstrøm, Thomas; Arslani, Ketina; Leone, Antonio Maria; Galante, Domenico; Van Nunen, Lokien X; Fearon, William F; Christiansen, Evald Høj; Fournier, Stephane; Desta, Liyew; Yong, Andy; Adjedj, Julien; Escaned, Javier; Nakayama, Masafumi; Eftekhari, Ashkan; Zimmermann, Frederik M; Sakai, Koshiro; Storozhenko, Tatyana; Da Costa, Bruno R; Campo, Gianluca; Berry, Colin; Collison, Damien; Johnson, Thomas; Amano, Tetsuya; Perera, Divaka; Jeremias, Allen; Ali, Ziad; De Bruyne, Bernard; Barbato, Paola; Corradetti, Sara; Stalikas, Nikolaos; Kechichian, Anthony; Bouisset, Frederic; Kakuta, Tsunekazu; Johnson, Nils P; Collet, Carlos. - In: CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS. - ISSN 1522-726X. - 107:4(2026), pp. 987-996. [10.1002/ccd.70419]
Impact of Sex on Residual Angina After Percutaneous Coronary Interventions
Corradetti, Sara;Kechichian, Anthony;
2026
Abstract
Background: Sex-related differences in the clinical presentation of coronary artery disease (CAD) are well recognized. The pullback pressure gradient (PPG) characterizes pathophysiological CAD patterns as focal or diffuse. Objectives: To evaluate the influence of sex on residual angina at one year after percutaneous coronary intervention (PCI), stratified by PPG. Methods: We performed a sub-analysis of PPG Global, a multicenter, prospective, single-arm study. All patients had hemodynamically significant CAD (fractional flow reserve [FFR] ≤ 0.80) and underwent a manual FFR pullbacks to calculate PPG before PCI. Patient-reported outcomes were collected using the 7-item Seattle Angina Questionnaire (SAQ-7) at baseline and 1-year follow-up. Results: We included 814 patients (205 [25.2%] women and 609 [74.8%] men). Women were significantly older than men (70 ± 10 years vs. 67 ± 10 years p < 0.001). Baseline FFR were comparable between sexes (0.68 ± 0.13 vs. 0.66 ± 0.12, p = 0.098), but women had a more focal CAD compared to men (PPG 0.66 ± 0.15 vs. 0.63 ± 0.15, p = 0.047). Post PCI-FFR was higher in women than men (0.88 ± 0.07 vs. 0.87 ± 0.07, p = 0.041); however, angina at 1 year was more frequent in women (SAQ angina frequency score 94 ± 12 vs. 96 ± 10, p = 0.041). Conclusion: Despite having a more focal CAD pattern and achieving higher post-PCI FFR, women report more residual angina than men at 1-year follow-up. Trial Registration: ClinicalTrials.gov NCT04789317.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
