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QFR-Guided Percutaneous Coronary Intervention Improves Outcomes

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.

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