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Prognostic value of quantitative flow ratio in patients with coronary heart disease after percutaneous coronary
Huaigang Chen1,2, Lang Hong2, Gang Xi3
1Medical College of Nanchang University, Nanchang, China.
Insights
Quantitative flow ratio (QFR) effectively predicts adverse cardiac events after percutaneous coronary intervention (PCI). Lower post-PCI QFR values indicate a higher risk of major adverse cardiac events, highlighting QFR
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Diagnostic Imaging
Background:
- Coronary atherosclerotic heart disease poses significant health risks.
- Current prognostic assessment methods after percutaneous coronary intervention (PCI) are suboptimal.
- There is a clinical need for improved methods to predict patient outcomes post-PCI.
Purpose of the Study:
- To evaluate the predictive capability of quantitative flow ratio (QFR) for adverse events following PCI.
- To determine the association between post-PCI QFR values and major adverse cardiac events, including vessel-oriented composite endpoints and target lesion failure.
Main Methods:
- A meta-analysis was conducted on eight studies comprising 4,173 patients and 5,688 vascular lesions.
- Data extraction and quality assessment were performed on clinical trials investigating QFR and adverse cardiac events post-PCI.
- Pooled hazard ratios (HR) and relative risks (RR) were calculated to assess the relationship between QFR and adverse outcomes.
Main Results:
- A pooled HR of 4.72 (95% CI: 3.29-6.75) indicated that QFR is a significant predictor of adverse events post-PCI.
- Lower post-PCI QFR values were strongly associated with an increased risk of individual clinical events.
- Specific relative risks were observed for cardiac death (RR: 6.51), myocardial infarction (RR: 4.83), and target vessel revascularization (RR: 4.21).
Conclusions:
- Quantitative flow ratio (QFR) demonstrates substantial potential for prognostic assessment in patients undergoing PCI.
- Measuring QFR post-PCI is crucial for accurate risk stratification.
- A reduced post-PCI QFR value serves as a critical indicator of increased risk for adverse cardiovascular events.
Background:
Coronary atherosclerotic heart disease is one of the most serious health and life-threatening diseases. There is no doubt that despite the increasing number of assessment methods used clinically, the prognosis assessment is still not ideal, and newer assessment methods are needed.
Objective:
To investigate the predictive value of quantitative flow ratio (QFR) for adverse events (vessel-oriented composite endpoint events/target lesion failure) in patients after percutaneous coronary intervention (PCI).
Method:
Eight studies involving 4,173 patients (5,688 vascular lesions) were included. These are studies on the relationship between QFR values and prognosis of adverse cardiac events after PCI. This meta-analysis was performed after quality assessment and data extraction of clinical trials data that met the inclusion criteria.
Result:
Each of the eight studies described the cut-off values for the best predictive ability of post-PCI QFR and the hazard ratio (HR) between QFR values and adverse events, respectively. The pooled HR of these studies was 4.72 (95% CI: 3.29-6.75). Concurrently, lower post-PCI QFR values were associated with the occurrence of individual clinical events (cardiac death/myocardial infarction/target vessel revascularization), with relative risk values of 6.51 (95% CI: 4.96-8.53), 4.83 (95% CI: 3.08-7.57), and 4.21 (95% CI: 2.66-6.68), respectively.
Conclusion:
QFR may have great potential in the assessment of prognosis. It is necessary to measure QFR value after PCI. A lower QFR value after PCI was an important predictor for experiencing adverse events.
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