30 Chapter 2 Figure 1 shows the prevalence of CCS endotypes per sex, on a per-vessel level. The analysis on a per-vessel level demonstrated consistent results with the per-patient level analysis. Supplementary Table 1 shows the CCS endotypes according to sex for CFR≤2.0 (the CFR threshold recommended by the recent European Society of Cardiology consensus document).16 Analyses according to both CFR≤2.0 and CFR≤2.5 yielded similar and consistent results. Figure 1. Prevalence of endotypes of CCS per sex on vessel-level, with the highest prevalence of normal coronary arteries in women and the highest prevalence of revascularization in men Abbreviations: TVF: Target Vessel Failure; oCAD: obstructive coronary artery disease; CMD: Coronary microvascular dysfunction; Revasc: Revascularization-group Long-term clinical outcomes determined by sex and CCS endotypes During a 5-year follow-up period, one or more TVF events occurred in 146 vessels (8.0%). Overall, the incidence of TVF events was relatively low across all CCS endotypes. Figure 2A depicts the per-vessel Kaplan-Meier time to event curves for TVF, stratified by sex. Sex, age, diabetes mellitus, positive family history, previous myocardial infarction, use of beta-blockers, use of nitrates, and the method used to measure coronary flow were all associated with 5-year TVF. After adjustment for these potential cofounders, patient sex remained an independent predictor of TVF, where men had a higher risk for TVF than women (HR.1.89, 95% CI 1.12–3.18, p = 0.018). Likewise, men had a trend towards a shorter mean survival time (14.6 years, 95% CI 13.9–15.3) compared to women (15.4 years, 95% CI 14.4–16.3).
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