Related Experiment Video
Updated: Jul 26, 2025
Author Spotlight: Improved Localization and Monitoring of Coronary Flow Reserve Using Modified PLAX View in Mice
Published on: August 25, 2023
Quantitative flow ratio as a continuous predictor of myocardial infarction
Changdong Guan1, Nils P Johnson2, Rui Zhang1
1Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Quantitative flow ratio (QFR) helps identify which coronary lesions benefit most from percutaneous coronary intervention (PCI). PCI reduces myocardial infarction (MI) risk for vessels with QFR ≤0.64 compared to medical therapy.
Area of Science:
- Cardiovascular medicine
- Interventional cardiology
- Diagnostic imaging
Background:
- Quantitative Flow Ratio (QFR) identifies functionally ischemic coronary lesions.
- These lesions may benefit more from percutaneous coronary intervention (PCI) than medical therapy.
Purpose of the Study:
- To investigate the association between QFR and myocardial infarction (MI).
- To evaluate the impact of PCI versus medical therapy on this association.
Main Methods:
- Analysis of 10,035 vessels from FAVOR III China and PANDA-III trials.
- Offline QFR measurements and per-vessel clinical outcome analysis.
- Cox proportional hazards model to assess interaction between vessel treatment and QFR for 2-year MI risk.
Main Results:
- PCI reduced MI risk in vessels with QFR ≤0.80 (3.0% vs 4.6%) but increased risk in vessels with QFR >0.80 (3.6% vs 1.2%) compared to medical therapy.
- Continuous QFR showed an inverse association with spontaneous MI, significantly reduced by PCI (HR 0.26).
- PCI provided a net benefit over medical therapy in reducing total MI starting at QFR ≤0.64.
Conclusions:
- A continuous inverse relationship exists between QFR and subsequent MI risk.
- PCI reduces MI risk compared to medical therapy for vessels with QFR ≤0.64.
- QFR serves as an angiographic tool for optimizing vessel selection for PCI.
