Coronary disease & ACSSecondary analysis
Sex differences in computed tomography-derived fractional flow reserve-guided management of stable coronary artery disease: a subgroup analysis of the TARGET trial
- post hoc subanalysis of the randomised TARGET trial
Authors' conclusion
CT-FFR-guided management was associated with different clinical patterns between females and males. Particularly in males, CT-FFR guidance reduced unnecessary angiography. A lower 2-year adverse event rate was observed among females in the CT-FFR group. However, given the absence of a statistically significant interaction between sex and treatment strategy, these findings should be considered exploratory and hypothesis-generating. (ClinicalTrials.gov: NCT03901326).
Study context
- Population
- Patients with stable coronary artery disease (CAD) with 30–90% coronary stenosis on coronary computed tomography angiography (CCTA)randomised
- Participants
- 1,216 patients
- Comparison
- onsite CT-FFR-guided care or standard care, by sex
- Primary endpoint
- proportion of patients who underwent ICA without obstructive CAD or had no intervention despite obstructive CAD on ICA
- Follow-up
- Within 90 days of CCTA
Primary result
As reported in the abstract
- CT-FFR-guided care significantly reduced invasive coronary angiography (ICA) without obstructive CAD and increased early revascularisation in males but not in females
Secondary outcomes
| Outcome | Values | adjusted HR (95% CI) | P value | |
|---|---|---|---|---|
| MACE (secondary endpoint) · 2 years — CT-FFR-guided care vs standard care · females | 0.48 (0.27–0.87) | P = 0.015 | ||
| MACE (secondary endpoint) · 2 years — CT-FFR-guided care vs standard care · males | 0.89 (0.59–1.33) | P = 0.574 | ||
| 0.20.5125Adjusted hazard ratio (log scale) |
| Outcome | Values | Estimate | P value |
|---|---|---|---|
| Age, females vs males · comparable anatomical CAD severity | Females mean 62.3 (SD 8.1) years · Males mean 58.2 (SD 10.7) years | P < 0.001 |
- Major adverse cardiovascular events (MACE) (secondary endpoint): no statistically significant interaction between sex and treatment strategy
Original publication
Sex differences in computed tomography-derived fractional flow reserve-guided management of stable coronary artery disease: a subgroup analysis of the TARGET trial. EuroIntervention. Published 7 September 2026. doi:10.4244/eij-d-25-01383
Summarised from the published abstract; every number is checked against it