One-year clinical outcomes improved with quantitative flow ratio for lesion selection versus standard angiography guidance
MONDAY, Nov. 15, 2021 (HealthDay News) — For patients undergoing percutaneous coronary intervention (PCI), a quantitative flow ratio (QFR) for lesion selection improves one-year clinical outcomes compared with standard angiography guidance, according to a study published online Nov. 4 in The Lancet to coincide with the annual Transcatheter Cardiovascular Therapeutics Conference (TCT 2021).
Bo Xu, M.B.B.S., from Peking Union Medical College in Beijing, and colleagues conducted a randomized trial at 26 hospitals in China involving patients aged 18 years or older with stable or unstable angina pectoris or patients who had a myocardial infarction at least 72 hours before screening and who had one or more lesions with a diameter stenosis of 50 to 90 percent in a coronary artery. Patients were randomly assigned to a QFR strategy (PCI performed only in QFR ≤0.80) or an angiography-guided strategy (PCI based on standard visual angiographic assessment). The intention-to-treat population included 3,825 participants (1,913 in the QFR-guided group and 1,912 in the angiography-guided group).
The researchers found that the one-year primary end point (one-year rate of major adverse cardiac events, defined as a composite of death from any cause, myocardial infarction, or ischemia-driven revascularization) occurred in 5.8 and 8.8 percent of participants in the QFR-guided and angiography-guided groups, respectively (hazard ratio, 0.65). The decrease was driven by fewer myocardial infarction and ischemic-driven revascularizations in the QFR-guided group.
“Based on these findings, following regulatory approval I would anticipate QFR to be widely adopted by interventional cardiologists to improve outcomes for their patients,” a coauthor said in a statement.
Several authors disclosed financial ties to the biopharmaceutical and medical device industries.
Abstract/Full Text (subscription or payment may be required)
Risk for MACCE, Mortality Higher for Women With Severe CAD Undergoing PCI Versus CABG 
P2Y12 Inhibitor Monotherapy Beneficial for Patients Who Undergo PCI 
De-Escalating DAPT to Ticagrelor Monotherapy Cuts Bleeding Risk in Acute Coronary Syndrome 
In-Hospital Mortality Rare After Percutaneous Coronary Intervention 
No Increase in Long-Term Mortality Seen With Peripheral Drug-Coated Devices 
Iliac Vein Stenting Appears Safe in Office-Based Lab Setting 
Benefit of Prolonged DAPT Following PCI Questioned 
FFR-Guided PCI Not Noninferior to CABG in Three-Vessel CAD 
